USAID KENYA NUTRITION AND HEALTH …pdf.usaid.gov/pdf_docs/PA00MN97.pdfUSAID KENYA NUTRITION AND HEALTH PROGRAM plus FY 2016 Q3 PROGRESS REPORT APRIL 1–JUNE 30, 2016 Award No: AID-615-H-15-00001

USAID KENYA NUTRITION AND

HEALTH PROGRAM PLUS

QUARTERLY PROGRESS REPORT

JULY 2016

This publication was produced for review by the United States Agency for International Development. It was prepared by Kenya Nutrition and Health Program plus

USAID KENYA NUTRITION AND

HEALTH PROGRAM plus

FY 2016 Q3 PROGRESS REPORT

APRIL 1–JUNE 30, 2016

Award No: AID-615-H-15-00001

Prepared for Ruth Tiampati

United States Agency for International Development/Kenya

C/O American Embassy

United Nations Avenue, Gigiri

P.O. Box 629, Village Market 00621 Nairobi, Kenya

Prepared by

Nutrition and Health Program plus

2nd Floor Chancery Building, Valley Road

P.O Box 38835 00623

Nairobi, Kenya

DISCLAIMER The authors’ views expressed in this report do not necessarily reflect the views of the United States Agency for

International Development or the United States Government.

i

USAID/KENYA NUTRITION AND HEALTH PROGRAM PLUS PROGRESS REPORT FOR Q3 FY 2016

I. NUTRITION AND HEALTH PROGRAM PLUS

EXECUTIVE SUMMARY ................................................ iv

I. Background ......................................................... 1

II. KEY ACHIEVEMENTS (Qualitative Impact) ............ 1

III. ACTIVITY PROGRESS (Quantitative Impact) ...... 10

IV. CONSTRAINTS AND OPPORTUNITIES ............. 18

V. PERFORMANCE MONITORING ............................ 18

VI. PROGRESS ON ENVIRONMENTAL

MITIGATION AND MONITORING ............................ 20

VII. PROGRESS ON LINKS TO OTHER USAID

PROGRAMS .................................................................... 20

VIII. PROGRESS ON LINKS WITH GOK

AGENCIES ...................................................................... 20

1X. SUBSEQUENT QUARTER’S WORK PLAN ........ 21

X. FINANCIAL INFORMATION .................................. 24

XI: ANNEXES & ATTACHMENTS: ............................. 25


ACRONYMS AND ABBREVIATIONS AIDS Acquired Immune Deficiency Syndrome

AMPATH Academic Model for Providing Access to Healthcare

APHIAplus AIDS, Population and Health Integrated Project

ART Antiretroviral Therapy

CBO Community-Based Organization

CCC Comprehensive Care Centers

CDC Centers for Disease Control

CHANIS Child Health and Nutrition Information System

CHEW Community Health Extension Worker

CHV Community Health Volunteer

CLTS Community-Led Total Sanitation

CNTF County Nutrition Technical Fora

CO Country Office

COP Chief of Party

CRISP Central Regional Integrated Program

CU Community Health Unit

DCOP Deputy Chief of Party

DHIS District Health Information System

EDL Economic Development and Livelihoods

EmOC Emergency Obstetric Care

EMR Electronic Medical Records

EMMP Environmental Mitigation and Monitoring Plan

ENA Essential Nutrition Actions

EPZ Export Processing Zone

FAFSA Food Aid and Food Security Assessment

FANTA Food and Nutrition Technical Assistance Project

FAO Food and Agriculture Organization

FBF Fortified Blended Food

FBP Food by Prescription

FFP Food for Peace

FHI Family Health International

FtF Feed the Future

GAIN Global Alliance for Improved Nutrition

GIS Geographic Information System

GMP Good Manufacturing Practice

GOK Government of Kenya

HACCP Hazard Analysis and Critical Control Points

HEA Household Economic Assessment

HFP Household Food Production

HiNi High impact Nutrition interventions

HIV Human Immunodeficiency Virus

HNDU Human Nutrition and Dietetics Unit

HTC HIV Testing and Counseling

IMAM Integrated Management of Acute Malnutrition

IP Implementing Partner

IR Intermediate Result


IYCF Infant and Young Child Feeding

IYCN Infant and Young Child Nutrition

KARI Kenya Agriculture Research Institute

KEBS Kenya Bureau of Standards

KDHS Kenya Demographic and Health Survey

KEMSA Kenya Medial Supplies Authority

KFDA Kenya Food and Drug Administration

KHCP Kenya Horticultural Competitiveness

KNDI Kenya Nutritionists and Dieticians Institute

KPPB Kenya Pharmacy and Poisons Board

LMIS Logistics Management Information System

M&E Monitoring and Evaluation

MEDS Mission for Essential Drugs and Supplies

MIYCN Maternal and Child Health Integrated Program

MNCH Maternal Newborn and Child Health

MOH Ministry of Health

MT Metric Ton

NACS Nutritional Assessment, Counseling and Support

NASCOP National AIDS and STI Control Program

NFSNSC National Food and Nutrition Security Secretariat

NHP Nutrition and HIV Program

NHPplus Nutrition and Health Program Plus

NICC Nutrition Interagency Coordinating Committee

NNAP National Nutrition Action Plan

NSR Nutrition Service Register

OR Operations Research

ORT Oral Rehydration Therapy

OVC Orphans and Vulnerable Children

PEPFAR President’s Emergency Program for AIDS Relief

PLHIV People Living with HIV

PAC Project Advisory Committee

PMEP Performance Monitoring and Evaluation Plan

PMTCT Prevention of Mother-To-Child Transmission of HIV

QA/QI Quality Assurance / Quality Improvement

RUTF Ready-to-use Therapeutic Food

SBC Social Behavior Change

SCNTF Sub-County Nutrition Technical Fora

SMT Senior Management Team

SUN Scaling Up Nutrition

TA Technical Assistance

TWG Technical Working Group

USAID United States Agency for International Development

WASH Water, Sanitation and Hygiene WFP World Food Program


I. NUTRITION AND HEALTH PROGRAM PLUS EXECUTIVE SUMMARY

Nutrition and Health Program plus is a five-year program running from January 1, 2015 to December

31, 2019. The program purpose is to increase access and demand for nutrition services, and improve

food and nutrition security as well as commodity management support. The program funding is from

three different streams: PEPFAR for commodity management support, Feed the Future (FtF) for

improving food and nutrition security, and MNCH/Nutrition for implementing MNCH interventions

that ensures greater effect for women and children under two years with regard to nutrition. Feed

the Future (FtF) activities are implemented in the Counties of Busia, Tharaka Nithi, Kitui, Samburu and

Marsabit, while MNCH activities are implemented in the counties of Busia, Tharaka Nithi, Kitui, and

Marsabit. Commodity management support is provided across all the 47 counties in Kenya. During

the period of April 1 through June 30, 2016, the program made progress towards achieving its

objectives. Details the project’s accomplishments, successes and challenges faced are summarized below.

Towards improving access and demand for quality nutrition interventions at community and facility

levels, a concept note has been developed to conduct Kenya PROFILES on nutrition. PROFILES uses

models and country-specific data to project the economic and health consequences of not adequately

addressing a country’s nutrition problems, illustrating what the negative consequences would be with

no improvement and no change in nutrition problems over a defined time period. It simultaneously

estimates the benefits of improved nutrition over the same time period, including lives improved and saved and economic productivity losses averted.

In the counties of Kitui, Samburu, Marsabit and Busia, 56 health facilities were assessed using the

National HiNi Gap assessment tool. This tool is used to assess health facilities capacity to manage

acute malnutrition. Based on the total scores achieved during assessment 4 health facilities were found

to have limited capacity (0-25%), 28 health facilities with moderate capacity (26-50%); 23 health

facilities with good capacity (51-75%) and 1 health facilities excellent capacity (76-100%) to manage acute malnutrition. This is an achievement of 103.7% against the set annual target of 54 health facilities.

As part of the support towards improving vitamin A supplementation coverage, the program

participated in the Malezi Bora activities held in May 2016. The program supported Vitamin A

supplementation for a total of 57,638 children (Tharaka Nithi-6,110, Marsabit-8,747, Kitui-25,099,

Busia-9,826, and Samburu-7,856). An achievement of 87.8% against the FY16 set target of 72,387. It is expected that this target will be surpassed by the end of the FY16.

The program supported a one-day consultative meeting organized by Nutrition and Dietetics Unit and

Scaling up Nutrition (SUN) Academia and Research Network (ARN) for 42 participants drawn from

universities, research institutions and other stakeholders from the donor community. During the

meeting national nutrition research priorities were determined. The program is working towards determining key operational research priorities that can be supported by the program.

To strengthen the technical capacity of the USG funded programs to support quality implementation

of NACS approach beyond HIV services; horizontal scale up across service points, integration of

NACS within routine care and treatment, provide better commodity management and nutrition

reporting including routine mentorship and OJT activities at health facility and community level, the

program conducted a two-day NACS training for 29 Nutrition officers and monitoring and evaluation

officers from local Implementing Partners.

To support provision of commodity interventions to malnourished clients, 29,667 cartons of Fortified

Blended Flours were procured from Equatorial Nut Processors comprising of 17,800 cartons (60%)

of FBF for Adolescents and Adults; 8,900 cartons (30%) of FBF for Children less than 9 years and 2,967

cartons (10%) of FBF for Pregnant and post-partum mothers. The procured FBF quantities exceeded

quarterly procurement targets by 15.5% and can serve approximately 15,000 patients. During the same


period 23,000 (77.5%) of FBF procured were distributed to 378 health facilities. During the same

period, the number of health facilities directly receiving FBF was increased from 350 to 378, an 8%

increase from previous quarter. The program supported a total of 857 health facilities with data

management and reporting representing an overall reporting rate of 85.7% of target facilities representing an increased facility reporting of 29.0% from the preceding quarter (857 vs 609).

Towards improving food and nutrition security, cooking demonstrations were conducted in the key

focus counties of Busia, Tharaka Nithi, Kitui, Samburu and Marsabit where a total of 404 community

members were provided with information on how to improve the quality of the food prepared and

learning how to modify food recipes to provide better nutrition value. Additionally, to improve

physical access and consumption of nutritious foods, two demonstration gardens were setup in

Mayenje and Burumba Primary ECDE centres in Mayenje and Burumba wards. The demonstration

gardens will be used to promote production and utilization of Vitamin A rich foods within the

community.

Towards improving resilience of vulnerable households and communities, the program in collaboration

with National Disaster Management Authority (NDMA) trained 61 NDMA Early Warning System Field

Monitors on correct screening of undernourished persons using MUAC within the communities. The

monitors will use the skills acquired to identify malnourished cases during their monthly assessments and refer them to health facilities for malnutrition management.

During the same period, a SMART survey was initiated in Samburu County. The population based

surveys are necessary for providing baseline data on the prevailing nutrition related indicators with a

view to setting targets. The overall objective is to determine the prevalence of malnutrition among the children aged 6- 59 months old and women of reproductive age of 15 to 49 years.

Towards achievement of the Monitoring and Evaluation Plans targets, the program is on track with

most of targets. During the quarter, the program completed assessment of 56 facilities within the focus

counties with capacity to manage acute malnutrition against an annual target of 54 heath facilities, an

achievement of 103.7%. To increase the number of people trained in child health and nutrition through

USG-supported programs, a total of 354 HCWs have been trained from the beginning of FY16, an

achievement of 164.7%. against the set target of 215.

To increase the number of children under five years reached by USG supported nutrition programs,

a total of 92,931 of under five children from the five focus counties, were reached,100.5% achievement

against the FY16 target of 92,484. A total of 63,557 of under five children have been provided with

Vitamin A supplementation through the programs, an achievement of 87.8% against the set target of

72,387.

By the end of FY16 Quarter 3, cumulatively 292,945 clients were nutritionally assessed using

anthropometric measurement, an achievement of 209% against the set target of 140,122 clients. During

the quarter, a total of 67,641 against a target of 62,285 clients were provided with Nutrition

Assessment, Counselling and Support. A total of 64,690 clinically malnourished PLHIV were provided

with therapeutic or supplementary food through the program, a 64.8% achievement against the set target of 99,885 for the FY16.

Although the program is on track, challenges in reaching children under five who are wasted and

children under five who are underweight still remains. The program is analyzing different sets of data

to understand whether the targets provided are reachable or not. Other indicators that are not on

track includes specifically process based targets that will take longer to achieve. These includes

creation of mechanisms to facilitate coordination, number of people trained/ Mentored, provided TA

at National Level and the number of tools/templates/models provided by target institutions in order to facilitate devolution at the local level as a result of USG assistance.

Challenges continue to be encountered in receiving commodity and service data from the facilities,

mainly attributed to staff turnover at facility level due and inadequate number of HCWs trained to

support nutrition. Due to intensive programming that is required in the key focus counties, the

program has also found the need to increase the number of staff in the key focus counties, specifically


to include staff with knowledge of home economics to provide the necessary skills required in food and nutrition security.

During the subsequent quarter, the program will upscale NACS, IMAM, MYCN and agri-nutrition

sensitive training, complete the SMART surveys in the focus counties, expand use of EMR to improve facility reporting and conduct PROFILES for the nutrition in the country.


I. BACKGROUND

The Kenya Nutrition and Health Program plus, a five-year program running from January 1, 2015 to

December 31, 2019 is a national program with county level mandates. The overall goal of the program

is to improve nutrition status of Kenyans. At the national level, the mandate of the program is to

increase access and demand for nutrition services and strengthen nutrition commodity management.

In addition to cascading these at county levels, the program works with Feed the Future partners in

the counties of Busia, Tharaka Nithi, Kitui, Samburu and Marsabit to improve food and nutrition

security. In the counties of Busia, Tharaka Nithi, Kitui and Samburu the program is implementing

Maternal Newborn and Child Health (MNCH) activities that aims at ending preventable child and

maternal deaths through ensuring a greater effect for women and children under two years with regards to nutrition.

The key results areas of the Nutrition and Health Program plus are improving access and demand for

quality nutrition interventions at community and facility levels, strengthening nutrition commodity

management and improving food and nutrition security. This report describes in detail the project’s

accomplishments, successes and challenges faced during the period of April 1 through June 30, 2016.

II. KEY ACHIEVEMENTS (QUALITATIVE IMPACT)

1. IMPROVED ACCESS AND DEMAND FOR QUALITY NUTRITION INTERVENTIONS AT COMMUNITY AND FACILITY LEVELS.

1.1. Strengthening Leadership, Advocacy and Policy Planning

During the quarter, the program developed a draft concept to conduct Kenya PROFILES on nutrition.

PROFILES uses models and country-specific data to project the economic and health consequences of

not adequately addressing a country’s nutrition problems, illustrating what the negative consequences

would be with no improvement and no change in nutrition problems over a defined time period. It

simultaneously estimates the benefits of improved nutrition over the same time period, including lives

improved and saved and economic productivity losses averted. Based on the projected consequences

and benefits, PROFILES results can be used to engage government and other high-level stakeholders

in a collaborative nutrition advocacy process to identify, prioritize, and advocate for evidence-based

actions to improve nutrition. The next steps include forming a core working group that oversees the

process and bringing together key stakeholders from multiple sectors, donors, and implementing

agencies to agree on a national approach for implementation of nutrition advocacy activities.

Towards strengthening leadership, the program is in discussions with the Busia County Government

to agree on a suitable candidate who can undertake Senior Management Course at The Kenya School

of Government, scheduled for August 2016 semester. When completed the cause will enable the

selected candidate to acquire competencies in strategic thinking and leadership that will impact the

county by improving her ability to provide informed insights and more effective analysis of key nutrition

issues in the county. Additionally, this will assist in retention of senior personnel who can fill in senior

positions that may arise such as CNC.

1.2. Improving Nutrition Service Delivery Management, Coordination and Implementation

During the quarter, a total of 56 HiNi target facilities were identified in Kitui, Samburu, Marsabit and

Busia. These facilities were identified through facility capacity assessment conducted in collaboration

with the County Health Management Teams (CHMT) using a standardised national HiNi Gap

assessment tool. This tool is used to assess health facilities capacity to manage acute malnutrition.

Facilities are ranked based on total scores achieved during assessment as either having limited capacity

(0 – 25%); moderate capacity (26 – 50%); good capacity (51 – 75%) and excellent capacity (76 – 100%).


In Kitui, the 26 facilities assessed scored above 26% indicating they have good capacity to manage acute

malnutrition. However, one facility had limited capacity due to limited infrastructure. In Busia, of the

18 facilities assessed 15 health facilities were identified as having adequate capacity to manage acute

malnutrition. In Samburu county, of the 5 facilities assessed all scored above 50% indicating that they

have a satisfactory capacity to manage acute malnutrition. In Marsabit, all 7 facilities assessed attained

a score of above 50% indicating that they have adequate capacity to manage acute malnutrition. The

mains gaps identified in most of the facilities included lack of functional anthropometric equipment and

insufficient staff trained on IMAM. The results of this assessment will be disseminated at county level to assist each county in development of mitigation strategies to address the identified gaps.

Table 1: Distribution of Facilities with Capacity to Manage Acute Malnutrition

County No of facilities

assessed

Ranking of Facilities Based on Total Scores

Achieved

<25% 26-50% 51-75% >76%

Kitui 26 1 18 6 1

Samburu 5 0 0 5 0

Marsabit 7 0 1 6 0

Busia 18 3 9 6 0

Total 56 4 28 23 1

As part of program support to MOH in improving Vitamin A supplementation coverage, the program

participated in the Malezi Bora activities held in May 2016. The theme for this years’ Malezi Bora

celebrations was “Afya ya Jamii, Ustawi wa nchi”. Activities conducted in the five focus counties of Kitui,

Tharaka Nithi, Busia, Samburu and Marsabit included participation in the County Malezi Bora planning

meetings, joint support supervision during vitamin A supplementation activities and support for

administration of deworming medication at health facility. In Tharaka Nithi, the program supported

Vitamin A supplementation for 6,110 children under five years in 190 ECD centres located in the

Chuka Igambangombe sub-county. This represented a coverage of 96.4% of vitamin A supplementation

in the sub county. In Marsabit, Saku sub-county, a total of 8,747 children under five years were

provided with vitamin A supplementation, with 5,641 children aged 12-59 months being dewormed.

This represents 82.1% coverage of vitamin A supplementation (VAS) within the sub-county. As part of

the program’s strategy of targeting children aged 3-5 years in ECD centres in Sololo sub-county 40

ECD centres were identified with a catchment of 1,460 children. In subsequent quarters, Moyale and

Loyangalani sub-counties will be profiled. In Kitui, within the

sub-counties of Mwingi East, Mwingi central, Mwingi West,

and Kitui south, a total of 25,099 children under five years

received vitamin A supplementation and deworming

medication. In the sub-counties of Matayos and Teso North

in Busia County’s, 9,826 children under five years received

Vitamin A supplementation. In Samburu, 78 ECD centres in

Samburu central and Samburu East were supported where

a total of 7,856 children under five were provide with Vitamin A supplementation.

Table 2: Summary of Vitamin A Supplementation and Deworming in Focus Counties. County No. of Children

supplemented with

vitamin A

No. of

children

dewormed

No of ECD

covered

% Coverage based

population of children

under 5 yrs.*

Tharaka Nithi 6,110 - 190 32%

Marsabit 8,747 - - 103%

Kitui 25,099 25,099 642 42%

Busia 9,826 - 244 21%

Samburu 7,856 - 78 35%

Total 57,638 * Coverage is based on population of children under five years in the respective sub-counties where Malezi bora activities were conducted


1.3. Improved Nutrition Related Behaviour

During the quarter, the program supported pre-testing of the MIYCN counselling card in Tharaka

Nithi county. The objective of the pretesting was to determine viability of the messages in catalyzing

appropriate behavior change. Key informant interviews (KII) and focus group discussions (FGD) were

conducted to collate required feedback, targeting audiences within urban and rural settings. These

target audiences included Health Care Workers, Mentor Mothers and Community Leaders (Local

Administration and Religious Leaders). Health Workers, Mothers, Community Health Volunteers

(CHVs), Youth Leaders, Fathers, Mother-to-Mother Support Group (MtMSG) and Grandmothers

participated in the FGDs during the pretesting. In addition, nine (9) FGDs with community groups of

ten (10) participants each were also conducted. Also, four (4) individual interviews targeting health

workers and community leaders were conducted. Preliminary recommendations to improvement of

the counselling card include the need for a counselling card with only illustrations and key messages for health care workers and community health volunteers.

During the quarter, the program conducted four (4) CMEs in the four (4) high volume health facilities

in Tharaka Nithi. The CMEs were attended by 89 health workers and provided an opportunity to brief

the HCWs on expectations for successful implementation of the Malezi Bora activities, addressed

reporting gaps for growth monitoring services, Vitamin A supplementation, Zinc, Deworming and the

entire Malezi Bora interventions; provided updates to HCWs on the integrated package of preventive

services for improving child health, survival, and maternal health; increased the utilization and improved

capacity for delivery of the 13 HiNi interventions based health and nutrition services for children,

expectant women, lactating mothers and women of reproductive age in Kenya and aided achievement of a complete implementation of breastfeeding policy in maternity facilities.

Towards increasing uptake of key nutrition behaviors, the program leveraged on campaigns held during

the Malezi Bora events to provide key messages regarding breastfeeding practices and complimentary

feeding practices. In Tharaka Nithi 1,154 people were reached with the key messages on

complimentary feeding. In Busia, Teso North and Matayos sub counties, 155 people were reached

with messages on appropriate complementary feeding and handwashing during critical times including

timely introduction of complementary foods, frequency, amount of feeds and consistency based on

age, use of variety of nutrient-rich foods, responsive feeding method and hygienic food preparation

were discussed. Messages for handwashing with soap during critical times, use of toilets and point of

use water treatment were also provided. In Samburu, similar messages were provided to 22 women

from Nyuat self-help group, Lkurotto village in Samburu central as well as 168 mothers in Kitui and 29 Women of reproductive age in Marsabit county.

Similarly, during the Malezi Bora activities held in May 2016 the program printed 1,000 Malezi Bora

Posters of Vitamin A (500 posters) and Good Nutrition (500 posters). The posters were in English

and Swahili versions and were distributed in the focus counties of Tharaka Nithi, Marsabit, Kitui, Busia and Samburu.

1.4. Increasing Opportunities for Learning and Sharing of Best Practices in

Nutrition

Towards supporting the government to determine national nutrition research priorities, the program

supported a one-day consultative meeting organized by Nutrition and Dietetics Unit and Scaling up

Nutrition (SUN) Academia and Research Network (ARN). The meeting was attended by 42

participants representing Tegemeo Institute, University of Nairobi, Egerton University, Kenyatta

University, Jomo Kenyatta University, KEMRI, Maseno University and Moi University; NDU, NASCOP,

MOALF-Home Economic Department, Ministry of Devolution and Planning-Planning unit, USAID

Kenya and UNICEF. During the consultative meeting key research areas were identified, scope of

research defined, as well as identification of analysis and synthesis required to support nutrition based

research. The program will continue to support the process of identifying key operational research

priorities areas for eventual implementation support by the program.


1.5. Increased knowledge and skills for health care workers

To ensure high quality of delivery and management of nutrition program activities, the program

conducted a two-day NACS training for 29 Nutrition officers and monitoring and evaluation officers

from Implementing Partners(IP). The participants were drawn from MCSP (2), APHIAplus Imarisha (3),

APHIAplus Kamili (3), CHS (2), AMPATHplus (2), APHIAplus Nuru ya Bonde (3), APHIAplus Western

(3), Department of Defense (3), APHIAplus Jijini (3), Lea Toto COGRI (3), EGPAF (2) and DHMH (1).

The purpose of the NACS training was to strengthen the technical capacity of the USG funded

programs to support quality implementation of NACS approach beyond HIV services; scale up

horizontal integration of NACS within health facilities, provide better commodity management and

nutrition reporting including routine mentorship and OJT activities at health facility and community

level.

During the quarter, as a follow up of the HiNi gap assessment activities, a five-day training on Integrated

Management of Acute Malnutrition (IMAM) was conducted in Busia County. The IMAM key areas of

training included in-patient management and outpatient management of severe and moderate acute

malnutrition. A total of 34 participants attended the training comprising of 3 sub county nutrition

officers, 7 Facility Nutritionists, 13 nurses, 5 clinical officers, 2 AMPATHplus Nutrition officers, and 4

APHIAplus Western Nutrition staff. 28 health care workers were drawn from 18 health facilities in Busia. The goal of this training is to improve health facilities capacity to manage acute malnutrition.

2. STRENGTHENED NUTRITION COMMODITY MANAGEMENT

The main objective of this intermediate result area is to improve the impact of all interventions by

ensuring efficiency in nutrition commodity procurement, management and distribution including ensuring high quality and safety of nutrition commodities procured.

2.1. Improving Production, Supply and Distribution of Nutrition Commodities

During the reporting period, approval to contract Equatorial Nut Processors for procurement of

Fortified Blended Flours (FBF) and Insta Products (EPZ) Ltd for procurement of RUTF, was provided

by USAID Contracting Officer for the period beginning from April, 2016 to December 31, 2017. The

approval allows for procurement of 205,550 cartons of FBF with a value of US$ 5,998,557.42 that can

cover approximately 157,587 patients. This will contribute to a more efficient and effective supply

chain where nutrition commodities are expected to be readily available with minimal delays in production and/or distribution to the health facilities.

During the quarter, 29,667 cartons of Fortified Blended Flours were procured from Equatorial Nut

Processors comprising of 17,800 cartons (60%) of FBF for Adolescents and Adults; 8,900 cartons (30%)

of FBF for Children less than 9 years and 2,967 cartons (10%) of FBF for Pregnant and post-partum

mothers. The procured FBF quantities exceeded quarterly procurement targets by 15.5% and can

serve approximately 15,000 patients.

Due to delay in DA1 Form approvals, RUTF procurement and delivery has been affected from

September, 2015. The program is working closely with the Insta Products (EPZ) Ltd to ensure that RUTF is procured and distributed during the coming quarter.

During the reporting period, 23,000 (77.5%) of FBF procured was distributed to 378 health facilities.

During the month of April, no distribution of commodities was conducted due to buffer stock provided

to the health facilities during the previous quarter. During the same period the number of health

facilities directly receiving FBF was increased from 350 to 378, an 8% increase from previous quarter.

Through the continued NACS trainings and collaboration with county governments and other Implementing Partners, it is envisaged that this number will rise significantly in the coming quarter.


Table 3: Summary of Procured and Distributed Nutrition Commodities FBF

Type

Jul-Sep 2015 Oct-Dec 2015 Jan-Mar 2016 Apr-Jun 2016

Procured Distributed Procured Distributed Procured Distributed Procured Distributed

FBF

Adults 17,667 14,610 21,200 18,268 18,578 19,392 17,800 13,872

FBF

Children 8,833 6,822 10,600 8,398 7,067 10,858 8,900 6,955

FBF

Mothers 2,944 2,045 3,533 3,596 4,022 12,007 2,967 2,177

TOTAL

(FBF) 29,444 23,477 35,000 30,261 29,667 42,257 29,667 23,004

RUTF 0 0 8,178 2,044 0 0

During the May 2016, Malezi Bora activities, the program provide support to Nutrition and Dietetics

Unit (NDU) in distribution of Vitamin A Supplements. 6,205 tins of 200,000IU and 5,445 tins of 100,000IU of Vitami A were distributed to 21 counties for use during the Malezi Bora campaigns

Towards improving reporting rates, site visits were conducted in Busia and Nairobi Counties. Five (5)

health facilities were visited namely Angurai Health Centre, Busia CRH, Kocholya SCH, Moding H/C.

Busia County, being a focus county for the program, was of particular interest as commodity supply

had not yet been decentralized. Facilities visited were previously supported by AMPATH and had

requisite capacity to receive, store and dispense commodities. As a result of the site visits, a follow up

refresher training is planned during the forthcoming quarters to strengthen commodity management

and reporting. In addition, coverage within the county will be increased to support reducing

malnutrition in the county.

During the quarter, the program supported a total of 857 health facilities with data management and

reporting representing an overall reporting rate of 85.7% (857/1000) of target facilities. Overall, there

was increased facility reporting rate of 29.0% from the preceding quarter (857 vs 609). 383 of these

facilities have been designated as commodity delivery points. To ensure improved facility reporting

rates in subsequent quarters, the program will continue to engage with CNCs, facility nutrition contact

persons and local APHIA+ partners to support joint CME/OJT, supervision sessions as well as sharing

of monitoring data reports. The program also plans to transition 17 additional high volume facilities

into EMR facilities. The program will also seek to promote previously designated “satellite sites” to delivery points to ensure wider reach in provision of NACS.

In addition to the site visits, reports received from Tharaka Nithi indicated that the quality of the

packaging material (cartons) had improved such that the corrugated boxes could be stacked up to 6 boxes high.

To mitigate against the reported stock out MOH 733B (Facility Summary for Nutrition Services) and

MOH 734B (Facility Consumption Data Report and Request for Nutrition Commodities), printing of

Jan-Mar 2015 Apr-Jun 2015 Jul-Sep 2015 Oct-Dec 2015 Jan-Mar 2016 Apr-Jun 2016

Procured - 16,869 29,444 35,000 29,667 29,667

Distributed - 15,357 23,477 30,261 42,257 23,004

-

16,869

29,444

35,000

29,667 29,667

- 5,000

10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000

NO

. O

F C

AR

TO

NS

QUARTER PERIOD

VOLUME OF FBF PROCURED AND DISTRIBUTED


additional data collection tools has been initiated. Distribution of MOH 733B is planned to completed in FY16 Quarter 4.

During the reporting period, personnel from the program continued to actively participate during the

NASCOP Monthly Commodity Security Steering Committee meetings. The focus within the quarter

was on strengthening Logistics Management Information Systems (LMIS) where NASCOP undertook

trainings in various counties on forecasting and quantification of commodities including nutrition

commodities mainly targeting the County Health Management Teams. Additionally, the program

continues to provide monthly consumption summaries to NASCOP to inform development of the two pager report.

During the quarter, the program continued to provide support on commodity and service data

reporting to approximately 857 health facilities in 43 Counties during implementation of Nutrition

Assessment, Counselling and Support (NACS)/FBP mainly within the CCC and MCH clinics.

Specifically, the program supported commodity and service data reporting from facility to National

(DHIS) levels through support for data management, provision of reporting tools and support

supervision/OJT activities.

2.2. Improving Quality and Safety of Food Commodities and Agricultural Products

Towards improving quality and safety of nutrition commodities, the program conducted a Supplier

Quality Audits (SQA) in Equatorial Nut Processors and Soy Afric Ltd. Due to ongoing maintenance

works and equipment installations, Insta Products (EPZ) Ltd did not participate during the biannual

SQA activity. Insta Products (EPZ) Ltd will be included in the next cycle of Suppler Quality Audits

programed for December 2016. The main objective of the Supplier Quality Audit is to monitor

progress made on implementation plans that the food processors had provided during December 2015

SQA. In addition, ISO 22000 and ISO 22002-2009 attainment status was checked. The 3 companies

were expected to have attained the ISO 22000 Food Safety certification before audit period. The

assessment criteria changed slightly from a hybrid of requirements in the previous audit to a pure ISO

22000:2005 and 22002-1:2008 during the current assessment.

ENP scored an overall average of 85.3%, a minimal improvement from the previous score of 84.9%.

The notable improvements especially by observation were in cleaning and sanitation in the factory and

staff facilities, as well as premises repairs and maintenance. The previous audit identified corrective

actions on documentation as a non-conformance. The documentation was either missing or actions

were not clear in various areas. Little or nothing has been done to improve on documentation. However, overall there were no major non-conformances found during the SQA.

Soy Afric Ltd scored an average of 38.8%, a minimal improvement from previous score of 32.4%.

Despite the Soy Afric Lt having a good facility, the client lacks historical evidence to demonstrate due

diligence as observed in production of their food products. The client has also attempted to document

food safety system, but there seems to be lack of internal capacity to complete documentation of food

safety system. The Supplier Quality Audit report will be disseminated to the respective processors in the coming quarter.

2.3. Strengthening Sustainability and Innovation in Nutrition Commodity Development and Management

Working closely with Equatorial Nut Processors, a concept paper has been prepared for development

of alternative FBF for management of moderate malnutrition. The concept paper provides a clear

description of the proposed products to be developed including a summary of what is already known

about the current products available for management of moderate malnutrition, a description of how

ENP will develop the proposed products including formulation of premixes in line with WHO/CODEX

recommendation for new micronutrient formulation for specialized FBF products, the data that will

be gathered or used; how the subcontractor will analyze the data; and how the data and analytic method will be used to develop the new product.


During the quarter, Equatorial Nut Processors was able to procure 111,420 Kg of Soya Beans from

Busia County, with a value of US$ 62,950. Soya beans is a key raw materials used in FBF production.

The program is working closely with Equatorial Nut Processors to link more farmers in the key focus

counties of Busia, Kitui, Tharaka Nithi, Marsabit and Samburu with the FBF processors to develop

sustainable markets for Maize, Soya Beans and Sorghum. Additionally, for traceability of agricultural

raw materials used in FBF processing, Equatorial Nut Processors have vetted 4 local suppliers of maize

and soya beans who have consistently met the minimum requirements. This is an important aspect of ensuring quality FBF procured through the program.

3. IMPROVED FOOD AND NUTRITION SECURITY

The main objective of this intermediate area is to break the cycle of malnutrition through providing

food and nutrition security to ensure prevention of recurrent malnutrition. Through targeted

interventions and smart integrations and linkages with other partners the programs enable individuals

and groups vulnerable to undernutrition to improve their overall food and nutrition security. Towards

improving food and nutrition security and in reducing stunting the program conducted several activities

that included promotion of dietary diversity practices especially focusing on food production through

improving physical access and consumption using appropriate food preparation techniques. Population

based surveys were also conducted to provide baseline data on the prevailing nutrition related

indicators. Linkages with various stakeholders were established to provide synergies and leverage on existing opportunities for bridging agri-nutrition gaps for increased nutrition outcomes.

3.1. Increasing Market Access and Consumption of Diverse and Quality Foods

To promote dietary diversity practices, cooking demonstrations were conducted in the key focus

counties. In Samburu county the program conducted cooking demonstration using sorghum and

pumpkin as key ingredients and source of vitamin A. The cooking demonstrations targeted 22 women

from Lkurotto Village, Nyuan Self Help Group who were shown how to prepare pilau, mandazi and

chapatis using sorghum and pumpkin. Sorghum is one

of the cereal in the market and also supplied through

GFD (General food distribution) but has a poor

utilization due to community’s lack of knowledge on its

utilization and the perception that sorghum is food for

the poor. Pumpkin leaves and fruits are good source of

vitamin A and can be prepared either as vegetables or

snacks. The group was also provided with key messages

on hand washing during food preparation to prevent common food contamination.

In Busia County three cooking demonstration were conducted within the communities living in Teso

North and Matayos sub-counties. The cooking demonstrations and nutrition education sessions were

used to address the energy, protein and micronutrient gaps that breastfeeding alone is not able to

meet after the 6 months. These included use of fats, peanut paste and sugar

in preparation of cereals and staples such as to improve energy and protein

density including taste, foods of animal origin, milk, vegetables and fruits to

meet protein, Iron, Calcium and Vitamin A requirements. 155 people were

reached during the cooking demonstrations, 120 people coming from Kolait

and Katotoi community groups in Teso North Sub-County and 35 people

from Burumba community group in Matayos Sub-County. The group was

provided with key information on breastfeeding and complimentary feeding

timing and age appropriate amount of feeds required, food consistency e.g. thin porridge and inappropriate feeding method e.g. forceful feeding.

In Tharaka-Nithi county, cooking demonstrations were conducted during

the Malezi Bora week targeting 30 mothers from Kibugua Mother-to-Mother support group. The

mothers were trained on preparing baby porridge made from Millet & Sorghum flour enriched with

cooking oil and sugar to make it energy dense and preparation of complementary food of mashed


bananas, potatoes, cow peas, pumpkin leaves and carrots. The gaps addressed being cooking

demonstrations included importance of timely introduction of appropriate complementary feeding,

safe preparation of foods, correct recipe and consistency of baby’s porridge.

In Kitui County, cooking demonstrations were conducted in 4 sub-counties of Kitui South, Mwingi

North, Mwingi west and Mwingi Central during the Malezi Bora week. The

cooking demonstrations focused on promotion of utilization of Sorghum

and cowpeas. Sorghum and cowpeas are common food grown in the

region but less consumed at the household level. The two crops do very

well in this semi-arid region and their nutritive value is high. The two crops

are good sources of iron, and more so the cowpeas leaves. Most of the

people consider the two as cash crops. The recipes used during the

cooking demonstrations were cereal porridge (sorghum & millet) and

mashed pumpkin, potatoes, bananas & cowpeas with cowpeas, spinach and

pumpkin leaves. The recipes are important in mitigating Vitamin A

deficiency and Anemia among women of reproductive age. During the

sessions 168 pregnant and lactating mother with children of up to 2 years

of age, who were trained on preparation of complementary feeds using

locally available nutritious foods and appropriate hygiene practices during

food preparation.

In Marsabit county one participatory cooking demonstration was conducted targeting 29 mother to

mother support group members during Malezi Bora week. The overall objective of the demonstration

was to impart practical know how on the best practices to prepare locally existing food hence

developing caregivers’ skills and confidence to prepare nutritionally sound meals. Sorghum was used

as the recipe of choice. Sorghum grows very well in Marsabit and drought tolerance, but has very

utilization mainly attributed to lack of adequate knowledge on its nutrient content as well as lack of

Knowledge on how to prepare sorghum appropriately. It is one of the cereal introduced in the region

by USAID due to its potential role in enhancing food security.

Towards improving physical access and consumption of nutritious foods, demonstrations gardens were

established in Busia. In Busia County, Matayos Sub-County two demonstration gardens were setup in

Mayenje and Burumba Primary school ECDE centres. The demonstration gardens were established

to promote production and utilization of Vitamin A rich foods (green leafy vegetables, carrots, orange

fleshed sweet potato, fruits tree (mangos, and custard apple). The 4K club members from the primary

school section participated in all the activities from land preparation, planting and management of the

gardens. The goal was for the 4K club members to learn how to grow the target nutrient dense foods and their importance. In Burumba 45 pupils participated during demonstration garden preparation.

In Tharaka Nithi County, Kibugua Mother-to-Mother Support Women group has been identified. The

Kibugua Mother-to-Mother Support group has been allocated a demonstration garden within Kibugua

Health Centre but garden has not been in use. The program intends to prepare this group’s

demonstration garden as a model garden where other groups can visit and learn from. The Women

group enthusiasm and organizational capacity will be utilised as a model group where other women

groups from the County and Sub-County will visit and learn from. Towards strengthening Kibugua

Mother-to-Mother Support Women demonstration garden a site assessment was conducted. The

assessment determined the type and number of seedlings required, tools and equipment needed to

establish the demonstration garden. When established the garden will produce a significant quantity

of food to eat and sell and act as a demonstration garden and agricultural trainings garden for other

groups within the community. Additionally, Kibugua mother-to-mother support women group and

their individual households group profiling was conducted. The group has the capacity to engage in

several activities that includes production and utilization through dietary diversification and increased

production technologies for food, nutrition security and resilience building.


3.2. Increasing Resilience of Vulnerable Households and Communities

Towards improving resilience of vulnerable households and communities, the program in collaboration

with National Disaster Management Authority (NDMA) trained 61 NDMA Early Warning System Field

Monitors on correct screening of undernourished persons using MUAC within the communities.

Those trained included 15 NDMA staff from Samburu, 22 from Marsabit and 24 from Kitui county.

The monitors will use the skills acquired to identify malnourished cases during their monthly

assessments and refer them to facilities for medication. Those found vulnerable will be referral to

safety net programs and livelihood activities within community structures. The vulnerable households

will also be linked to community livelihood programs that will help them avoid relapse. Already in

Samburu NDMA Field Monitors have identified 2 children with MUAC of less than 12cm from Arsim

location within community during their monthly routine assessments. These have been referred to

Arsim dispensary for nutrition support. Additionally, 114 vulnerable clients have been identified from

Busia (71), Kitui (4), Marsabit (2), Samburu (30) and Tharaka Nithi (7) health facilities that requires

linkages to safety net programs and livelihood activities within the communities.

In Marsabit County, a mapping exercise for the existing social safety net programs was conducted. The

social safety net programs identified includes Hunger safety net plan, disabled cash transfers, orphans and vulnerable children and older persons.

During the quarter, a SMART survey was initiated in Samburu County. The population based surveys

are necessary for providing baseline data on the prevailing nutrition related indicators with a view to

setting targets. The overall objective was to determine the prevalence of malnutrition among the

children aged 6-59 months old and women of reproductive age of 15 to 49 years. The specific

objectives were to determine the prevalence of acute malnutrition among children aged 6-59 months;

estimate prevalence of maternal malnutrition using MUAC, determine the immunization coverage for

measles, Oral Polio Vaccines (OPV 1 and 3), and vitamin A supplementation in children aged 6-59

months; determine de-worming coverage for children aged 12 to 59 months; estimate the use of zinc

in diarrheal treatment in children; determine the prevalence of common illnesses; determine Iron folic

acid supplementation rates among PW and to collect information on possible underlying causes of

malnutrition such as household food security, water, sanitation, and hygiene practices. The target

population were household with children 6-59 months and pregnant and lactating women. When

completed the SMART survey will provide critical information that will guide reduction of stunting in Samburu County.


III. ACTIVITY PROGRESS (QUANTITATIVE IMPACT)

Nutrition and Health Program plus MEP has provided for the following indicators and their target.

Below is a summary of each indicators progress by the end of FY16 Quarter 3.

Number of health facilities with established capacity to manage acute under nutrition:

The FY16 target for this indicator was set at 54 health facilities. By the end of the FY16 quarter 3, the

program has identified 56 facilities within the focus counties with capacity to manage acute malnutrition

against an annual target of 54 heath facilities. This is an achievement of 103.7% against the set annual

target. These facilities were identified through assessment of health facilities within the county’s using

the HINI gap assessment tool. Additional facilities from Marsabit are in the process of being identified.

Number of people trained in child health and nutrition through USG-supported

programs: A total of 354 HCWs have been trained from the beginning of FY16. This is an

achievement of 164.7%. against the set target of 215. Of those trained 183, have been trained in child

health and nutrition from Busia and Tharaka Nithi county. Once target facilities for management of

malnutrition have been fully identified, additional MIYCN training will be conducted during FY16

Quarter 4 for the remaining focus counties.

Number of children under five years reached by USG supported nutrition programs: The

program has successfully reached a total of 92,931 out of a target of 92,484 of under five children from

the five focus counties,100.5% achievement against the FY16 set target. Those reached includes clients

provided with Vitamin A supplement provide through the ECD centers during the Malezi Bora week.

Number of children under 5 who received Vitamin A from USG supported programs:

Through provision of TA (support for CMEs and OJT) during Malezi Bora, distribution of Vitamin A

from NDU and KEPHI the program has supported Vitamin A supplementation for a total of 63,557 of

under five children out of a target of 72,387, an achievement of 87.8% against the set target. The

program will continue to provide capacity building and reporting tools to ECD centers and health

facilities in support of Vitamin A supplementation for the under-fives. It is expected that by the end

of FY16 the program will exceed the annual target.

Number of children under five who are wasted: Number of under-five wasted children from

the five focus counties was reported to be 12,356 out of an overall target of 3,747 for the financial year.

Number of children under five who are underweight: Underweight children under five were

reported to be 184 against an expected target of 8,033 for the financial year. Additional training and

mentorship for client assessment will be conducted within the focus counties to ensure competence

in case identification. In addition, the program will provide anthropometric equipment, reporting tools

and EMR systems at CCC and MNCH service points to strengthen data quality.

Percentage of PLHIV who are nutritionally assessed via anthropometric measurement:

During FY16, 140,122 clients were to be provided with the nutrition assessment using anthropometric

measurement. By the end of FY16 Quarter 3, cumulatively 292,945 clients had undergone nutritional

assessment using anthropometric measurement, an achievement of 209%.

During the quarter, a total of 67,641 against a target of 62,285 clients were provided with Nutrition

Assessment, Counselling and Supports. Of those provided with NACS, approximately 48.9% were

newly enrolled clients. CCC service points recorded the largest of patients seeking nutrition services,

followed by MCH and Inpatient/Other clinics at 67.0%, 4.0% and <2% respectively. Of the total clients

provided with NACS, 74.6% and 25.4% were children and adult clients respectively. Table below shows

the distribution of clients provided with Nutrition Assessment, Counselling and Supports. 13,832 adult

and 2,767 child clients from EDARP have not been included for luck of client-identification information in their records.


Table 4: Distribution of assessed clients

Client category Number* of clients (%)

Adult PLHIV 34,885 (68.3%)

OVC 6-59 months 9,472 (18.6%)

Pregnant 1,774 (3.5%)

5-17 years 4,911 (9.6%)

Total *51,042 (100.0%)

*13,832 adult and 2,767 child clients from EDARP missing client-identification information

Proportionately, 7.6% (n=22,797) of the assessed adult clients were reported to be severely

malnourished with BMI of <16. Clients with BMI>18.5 seeking nutrition services during the visit 1 was

69.5% of non-PPP clients (n=22,797). Overall BMI reporting Rae for adult clients was reported at

93.3% (n=34,885). Of the 1,774 PPP clients supported during the reporting period, 54.3% were newly enrolled clients. Overall MUAC reporting rate for PPP clients was recorded at 44.4%

Table 5: Nutrition Status of adult Clients

BMI Category Visit Type Total

New Revisit

<16 1,730 (7.6%) 831 (8.2%) 2,561 (7.8%)

16-17 1,554 (6.8%) 915 (9.1%) 2,469 (7.5%)

17-18.5 3,660 (16.1%) 2,132 (21.1%) 5,792 (17.6%)

>18.5 15,853 (69.5%) 6,220 (61.6%) 22,073 (67.1%)

Total 22,797 (100.0%) 10,098 (100.0%) 32,895 (100.0%)

Table 6 below shows the weight-for-height status for the 9,472 under five children who were

provided with Nutrition Assessment, Counselling and Supports during the FY16 Quarter 3. 200 children have not been included due to missing anthropometric data in the records.

Table 6: Nutrition Status of Newly Enrolled Under 5-Year-Old Clients

WHZ 6-24 months 24-59 months Total

< -3 1,084 (14.7%) 202 (10.8%) 1,286 (13.9%)

-3 to -2 1,292 (17.5%) 251 (13.4%) 1,543 (16.6%)

-2 to -1 1,803 (24.4%) 395 (21.1%) 2,198 (23.7%)

> -1 3,217 (43.5%) 1,028 (54.8%) 4,245 (45.8%)

Total 7,396 1,876 **9,272

**200 children missing anthropometric data

Proportion of clinically undernourished PLHIV who received therapeutic or

supplementary food: By the end FY16 Quarter 3, cumulatively, a total of 64,690 clinically

malnourished clients were provided with therapeutic or supplementary food through the program.

The FY16 program target is to provide 99,885 clinically undernourished PLHIV with therapeutic or

supplementary food. By the end FY16 Quarter, using the data already received 64.8% of the target had

been achieved. Data for the month of June has not yet been received for entry in the data base. When

received, the number of clinically malnourished clients provided with therapeutic or supplementary

food through the program will be higher. The program will continue to engage implementing partners,

community groups, field extension workers, and in building capacity for HCWs, CHVs and facilities

through provision of job aids, tools and electronic support to support identification for the PLHIV

requiring therapeutic or supplementary food. It is envisaged that this will stimulate improved case

finding and improved case detection of clients in need of intervention.

During FY 16 Quarter 3, a total of 14,490 clients were provided prescriptions for therapeutic or

supplementary food through supported facilities, representing a 26.2% (14,490 vs 18,285) reduction

from the previous quarter. An additional 15,638 client records provided with nutrition assessments

have been received during the writing of the report. Digitization of these reports will be completed

early August, 2016, with subsequent feedback reports to respective CNCs and the NDU/NASCOP


commodity security committee prepared and shared. A profile of clients receiving therapeutic or supplementary food during FY 16 Quarter 3 is shown in Table 6.

Table 7: Number of clients receiving commodities by “client category”

Client category Number* of clients (%)

Adult PLHIV 8,190 (58.6%)

OVC 6-59 months 4,180 (29.9%)

Pregnant 529 (3.8%)

5-17 years 1,077 (7.7%)

Total 13,976 (100.0%)

514 cases are not included due to missing data for categorization comprising of 112 and 402 Adult and

Child clients respectively. Figure 1 below provides the trend in commodity dispensing (prescriptions)

between July 2015 and June 2016.

Figure 1: Trend in Commodity Prescriptions Between July 2015 And June 2016

Number of mechanisms created to facilitate coordination on an ongoing basis as a result

of USG Assistance at national level: The program supported 10 MOH led county multidisciplinary

coordination meetings during this financial year as per required target.

Number of people trained. Mentored, provided TA at National Level: The program is in the

final phases of actualizing the first program supported intake of county nutrition coordinators from the focus counties into the management program at Kenya School of Government.

% of county officials trained who demonstrate increased knowledge in training as result

of USG support: The program has recently supported constitution of Ministry of Health Operational

Research TWG to consultatively determine the country’s nutrition research priorities. The first

consultative meeting with interested partners research and academia was conducted and supported

by NHPplus during the third quarter. Arising from these, the program will support TWG secretariat

operations and additionally support dissemination forums during FY16 Quarter 4 and subsequent

financial years. These forums will not only support dissemination to research and academia peers but

also to county and national HCWs and implementers. Capacity building for focus county health executives in Samburu to develop and implement SMART surveys has also been completed.

Number of people trained: During the financial year, the program has supported SCALE ToT

training for 31 out of an expected target of 125 comprising of MOH and USG Implementing Partner ToTs from designated focus counties.

-

2,000

4,000

6,000

8,000

10,000

12,000

June July August September October November December January February

Y6-Q2 Y6-Q3 Y6-Q4

2014

Met

ric

To

ns

(FB

F)

FBFNew FBFRevisits FBF Total


Number of mechanisms created to facilitate coordination on an ongoing basis as a result

of USG Assistance at county level: The program supported drafting and adoption of terms of

reference for establishment or re-activation of county nutrition technical forums in Busia, and Kitui:

The program will utilize additional expert TA during the fourth quarter to cascade SCALE methodology to the focus counties.

Number of people trained. Mentored, provided TA at County Level: (people/TOTs trained

in SBC strategies, dietary diversification and financial inclusion, L/FFS, Food nutrition resilience, Income

generating value chains targeting women): The programs in the process of identifying community

groups within the counties Parallel to this, the program is in contact with USG Implementing Partners and MOALF to develop and implement a suitable training curriculum on dietary diversification.

Number of tools/templates/models provided by target institutions in order to facilitate

devolution at the local level as a result of USG assistance: During the quarter, the program

sought to identify community settings as potential channels for targeted messages and associated

information gaps specific to each county. Based on this, the program is finalizing acquisition of GOK

approved material for subsequent contextualization of nutrition and agri-nutrition job aids and tools

to assist CHVs in targeting and identification of vulnerable groups. Nutrition specific job aids targeting

ECD centers and MNCH service points will be distributed in FY16 Quarter 4. During the FY16

Quarter 4, 1,000 Malezi Bora Posters of Vitamin A (500 posters) and Good Nutrition (500 posters)

were printed and distributed to key focus counties.

14


Table 8: Performance data table: Commodities Distributed in MT INDICATOR TITLE: Number of MT of Commodities Distributed

INDICATOR NUMBER: SC_STOCK

UNIT: DISAGGREGATE BY: COUNTY

Geographic Location Activity Title Date: M

All counties except Mandera Reporting

Results:

Additional Criteria Baseline (January

2015)

Results Achieved

Prior Periods

Reporting Period 31/Dec/15

Reporting Period 31/Mar/16

Reporting Period 30/Jun/16

FY 2016 Target % Achievement If other criteria are

important, add lines for setting targets and tracking

County % December

2015

Target Achieved Target Achieved Target Achieved Target Achieved

N N N N N N N N N N

Baringo 1.7% 27 36.15 10.36 26.19 10.36 4.55 10.36 4.09 31 35 >100%

Bomet 0.9% 14 29.64 5.29 17.91 5.29 4.16 5.29 3.28 16 25 >100%

Bungoma 0.9% 15 60.56 5.65 19.87 5.65 31.24 5.65 10.04 17 61 >100%

Busia 0.3% 5 84.95 1.72 20.76 1.72 53.67 1.72 18.32 5 93 >100%

Elgeyo

Marakwet

0.4% 6 22.39 2.21 13.77 2.21 3.11 2.21 1.46 7 18 257%

Embu 4.6% 72 40.83 27.49 14.94 27.49 11.76 27.49 - 82 27 33%

Garissa 0.8% 12 2.57 4.75 0.54 4.75 1.53 4.75 - 14 2 14%

Homa Bay 4.9% 77 128.51 29.41 30.68 29.41 63.25 29.41 35.83 88 130 >100%

Isiolo 0.6% 9 18.59 3.33 - 3.33 9.31 3.33 2.47 10 12 >100%

Kajiado 1.2% 19 29.60 7.25 3.35 7.25 20.63 7.25 0.86 22 25 >100%

Kakamega 1.9% 30 51.49 11.44 22.05 11.44 12.07 11.44 12.80 34 47 >100%

Kericho 2.4% 38 9.48 14.32 4.05 14.32 1.12 14.32 - 43 5 12%

Kiambu 2.2% 34 76.58 13.15 15.92 13.15 40.66 13.15 10.06 39 67 >100%

Kilifi 1.2% 18 21.31 6.95 - 6.95 6.60 6.95 9.63 21 16 76%

Kirinyaga 1.7% 27 42.68 10.31 19.28 10.31 16.04 10.31 26.86 31 62 >100%

Kisii 0.9% 15 22.46 5.63 6.43 5.63 1.80 5.63 4.59 17 13 76%

Kisumu 4.2% 65 156.66 24.95 58.73 24.95 28.39 24.95 18.43 75 106 >100%

Kitui 1.0% 16 45.90 6.17 6.75 6.17 15.28 6.17 6.52 18 29 >100%

Kwale 0.5% 8 20.09 2.94 4.23 2.94 7.11 2.94 2.02 9 13 >100%

Laikipia 0.2% 4 12.26 1.39 - 1.39 7.52 1.39 7.74 4 15 >100%

Lamu 0.9% 14 6.86 5.49 - 5.49 3.73 5.49 2.61 16 6 38%

Machakos 2.8% 43 48.42 16.61 29.84 16.61 5.18 16.61 7.34 50 42 84%

Makueni 0.7% 11 30.24 4.36 10.84 4.36 11.97 4.36 11.43 13 34 >100%

Mandera 0.0% - - - - - - - - - -

Marsabit 0.6% 8 6.49 3.18 1.98 3.18 1.98 3.18 8.03 10 12 >100%

Meru 1.6% 24 40.28 9.19 9.00 9.19 8.37 9.19 8.86 28 26 93%

Migori 2.9% 45 99.01 17.19 29.93 17.19 25.33 17.19 9.61 52 65 >100%

Mombasa 5.4% 86 52.09 32.80 3.60 32.80 12.37 32.80 11.70 98 28 29%

Murang'a 2.2% 34 29.50 12.91 - 12.91 7.81 12.91 12.19 39 20 51%

Nairobi 6.4% 100 194.42 38.19 55.56 38.19 54.58 38.19 23.60 115 134 >100%

Nakuru 1.8% 29 49.01 10.95 11.63 10.95 15.13 10.95 17.08 33 44 >100%

Nandi 1.8% 29 27.40 10.96 4.70 10.96 18.18 10.96 - 33 23 70%

Narok 0.8% 12 34.65 4.74 5.87 4.74 21.10 4.74 1.40 14 28 >100%

Nyamira 0.0% - 9.78 - 2.36 - 2.68 - 1.67 - 7 -

Nyandarua 1.8% 29 33.83 10.96 4.93 10.96 17.27 10.96 8.24 33 30 91%

Nyeri 2.1% 32 40.13 12.26 0.72 12.26 18.35 12.26 11.65 37 31 84%

Samburu 0.6% 9 28.86 3.30 - 3.30 17.55 3.30 14.03 10 32 >100%

Siaya 5.0% 78 139.50 29.96 35.71 29.96 66.35 29.96 35.80 90 138 >100%

Taita Taveta

1.3% 20 19.59 7.69 - 7.69 12.17 7.69 3.44 23 16 70%

Tana River 0.1% 1 10.97 0.36 - 0.36 6.84 0.36 - 1 7 >100%

Tharaka Nithi

1.6% 25 31.66 9.57 10.89 9.57 11.88 9.57 3.83 29 27 93%

Trans Nzoia

0.4% 6 24.41 2.47 6.48 2.47 16.88 2.47 3.38 7 27 >100%

Turkana 2.6% 40 55.13 15.35 16.67 15.35 16.24 15.35 29.26 46 62 >100%

Uasin

Gishu

0.0% - 37.99 - - - 36.98 - 3.26 - 40 -

Vihiga 0.7% 11 24.80 4.30 10.75 4.30 5.39 4.30 10.66 13 27 >100%

Wajir 0.1% 2 4.39 0.64 2.32 0.64 1.57 0.64 - 2 4 >100%

West Pokot

0.3% 5 12.24 1.84 5.47 1.84 5.01 1.84 - 6 10 >100%

Blank 0.4% 7 - 2.57 2.57 2.57 8 - -

Total 100.0% 1,211 2,004 462.50 544.70 463 760.63 463 414 1,800 1,719 96%

15


Table 9: Performance data table: Number of PLHIV Nutritionally Assessed INDICATOR TITLE: Number of PLHIV nutritionally assessed via anthropometric measurement

INDICATOR NUMBER: FN_ASSESS


Geographic Location Activity Title

M

ALL Data Management, Reporting

Results:

Additional Criteria Baseline (January

2015)

Results Achieved

Prior Periods




FY 2015/16 Target % achievement If other criteria are


County % alloc


N N N N N N N N N N

Baringo 1.7% 4,904 2,363 709 1,418 709 945 709 1,259 2,838 3,622 >100%

Blank 0.4% 1,215 2,813 167 1,644 167 1,169 167

668 2,813 >100%

Bomet 0.9% 2,504 1,722 376 714 375.59 1,008 376 724 1,502 2,446 >100%

Bondo

- 1,013 - 1,013 -

-

- 1,013 -

Bungoma 0.9% 2,674 2,865 376 24 375.59 2,841 376 2,510 1,502 5,375 >100%

Busia 0.3% 815 5,390 125 1,524 125 3,866 125 2,718 501 8,108 >100%

Elgeyo Marakwet

0.4% 1,045 553 167 245 167 308 167 27 668 580 86.9%

Embu 4.6% 13,019 2,772 1,920 2,550 1,920 222 1,920 985 7,679 3,757 48.9%

Garissa 0.8% 2,250 1,472 334 1,175 334 297 334 634 1,335 2,106 >100%

HomaBay 4.9% 13,928 3,455 2,045 75 2,045 3,380 2,045 3,875 8,180 7,330 89.6%

Isiolo 0.6% 1,575 1,243 250 696 250 547 250 531 1,002 1,774 >100%

Kajiado 1.2% 3,431 1,985 501 1,985 501

501 694 2,003 2,679 >100%

Kakamega 1.9% 5,415 2,171 793 1,451 793 720 793 2,013 3,172 4,184 >100%

Kericho 2.4% 6,782 217 1,002 217 1,002

1,002

4,006 217 5.4%

Kiambu 2.2% 6,225 3,419 918 1,557 918 1,862 918 1,930 3,672 5,349 >100%

Kilifi 1.2% 3,293 435 501 435 501

501 513 2,003 948 47.3%

Kirinyaga 1.7% 4,882 3,493 709 2,334 709 1,159 709 161 2,838 3,654 >100%

Kisii 0.9% 2,664 1,170 376 963 376 207 376 183 1,502 1,353 90.1%

Kisumu 4.2% 11,812 3,112 1,753

1,753 3,112 1,753 1,618 7,011 4,730 67.5%

Kitui 1.0% 2,919 674 417 212 417 462 417 119 1,669 793 47.5%

Kwale 0.5% 1,391 378 209 161 209 217 209 137 835 515 61.7%

Laikipia 0.2% 657 1,978 83 1,805 83 173 83 115 334 2,093 >100%

Lamu 0.9% 2,598 1,737 376 1,737 376

376

1,502 1,737 >100%

Machakos 2.8% 7,865 2,523 1,169 181 1,169 2,342 1,169 2,403 4,674 4,926 >100%

Makueni 0.7% 2,062 1,865 292 271 292 1,594 292 2,567 1,169 4,432 >100%

Mandera 0.0% - 1,177 - 1,177 -

-

- 1,177 -

Marsabit 0.6% 1,507 4,730 250 4,605 250 125 250

1,002 4,730 >100%

Meru 1.6% 4,350 327 668

668 327 668 458 2,671 785 29.4%

Migori 2.9% 8,139 28,983 1,210 27,988 1,210 995 1,210 494 4,841 29,477 >100%

Mombasa 5.4% 15,531 7,019 2,254 1,592 2,254 5,427 2,254 2,842 9,014 9,861 >100%

Murang'a 2.2% 6,115 6,822 918 4,694 918 2,128 918 581 3,672 7,403 >100%

Nairobi 6.4% 18,084 21,780 2,671

2,671 21,780 2,671 20,640 10,684 42,420 >100%

Nakuru 1.8% 5,184 4,073 751 485 751 3,588 751 3,776 3,005 7,849 >100%

Nandi 1.8% 5,190 4,032 751 1,178 751 2,854 751 2,033 3,005 6,065 >100%

Narok 0.8% 2,244 169 334

334 169 334 226 1,335 395 29.6%

Nyamira 0.0% - 1,059 - 1,059 -

-

- 1,059 -

Nyandarua 1.8% 5,188 401 751 106 751 295 751 278 3,005 679 22.6%

Nyeri 2.1% 5,803 854 876 25 876 829 876 821 3,506 1,675 47.8%

Samburu 0.6% 1,565 996 250 794 250 202 250 291 1,002 1,287 >100%

Siaya 5.0% 14,188 1,156 2,087 442 2,087 714 2,087 601 8,347 1,757 21.1%

Taita

Taveta

1.3% 3,643 2,730 543 2,708 543 22 543 88 2,170 2,818 >100%

Tana River 0.1% 172 442 42 442 42

42

167 442 >100%

Tharaka

Nithi

1.6% 4,530 627 668

668 627 668 640 2,671 1,267 47.4%

TransNzoia 0.4% 1,169 598 167

167 598 167 1,132 668 1,730 >100%

Turkana 2.6% 7,268 1,618 1,085

1,085 1,618 1,085 1,331 4,340 2,949 67.9%

Uasin

Gishu

0.0% - 4,846 -

- 4,846 - 2,693 - 7,539 -

Vihiga 0.7% 2,034 59 292 40 292 19 292 2,940 1,169 2,999 >100%

Wajir 0.1% 302 - 42

42

42

167 - 0.0%

West Pokot

0.3% 871 1,058 125 1,044 125 14 125 60 501 1,118 >100%

Total 100.0% 219,000 146,374 32,301 72,766 32,301 73,608 32,301 67,641 166,931 214,015 >100%

16


Table 10: Performance data table: Number of clinically malnourished clients receiving commodities INDICATOR TITLE: Number of HIV positive clinically malnourished clients who received therapeutic and/or supplementary food

INDICATOR NUMBER: FN_THER


Geographic Location Activity Title

M


Results:

Additional Criteria Baseline

(January

2015)

Results Achieve

d Prior Periods




FY 2015/16 Target %Achievem

ent

If other criteria are


County % Target Achieved

Target Achieved

Target Achieved

Target Achieved

N N N N N N N N N N

Baringo 1.7% 1,668 68 425 425 68 425 163 1,698 231 13.6%

Blank 0.4% 852 219 100 132 100 87 100 400 219 54.8%

Bomet 0.9% 910 272 225 144 225 128 225 135 899 407 45.3%

Bondo 277 - - - - - - -

Bungoma 0.9% 356 550 225 56 225 494 225 616 899 1,166 >100%

Busia 0.3% 4,429 563 75 152 75 411 75 587 300 1,150 >100%

Elgeyo

Marakwe

t

0.4% 766 43 100 23 100 20 100 8 400 51 12.8%

Embu 4.6% 4,739 336 1,149 249 1,149 87 1,149 398 4,595 734 16.0%

Garissa 0.8% 536 - 200 200 200 56 799 56 7.0%

Homa Bay

4.9% 1,167 2,646 1,224 1369 1,224 1277 1,224 1185 4,894 3,831 78.3%

Isiolo 0.6% 1,842 373 150 276 150 97 150 209 599 582 97.1%

Kajiado 1.2% 2,308 41 300 41 300 300 98 1,199 139 11.6%

Kakamega

1.9% 2,118 616 474 306 474 310 474 344 1,898 960 50.6%

Kericho 2.4% 1,120 36 599 36 599 599 2,397 36 1.5%

Kiambu 2.2% 1,661 1,479 549 433 549 1046 549 1079 2,197 2,558 >100%

Kilifi 1.2% 906 126 300 126 300 300 88 1,199 214 17.9%

Kirinyaga 1.7% 4,019 1,435 425 683 425 752 425 67 1,698 1,502 88.5%

Kisii 0.9% 993 605 225 408 225 197 225 175 899 780 86.8%

Kisumu 4.2% 473 1,766 1,049 756 1,049 1010 1,049 422 4,195 2,188 52.2%

Kitui 1.0% 224 465 250 252 250 213 250 74 999 539 54.0%

Kwale 0.5% 884 8 125 125 8 125 71 499 79 15.8%

Laikipia 0.2% 2,676 314 50 182 50 132 50 105 200 419 >100%

Lamu 0.9% 702 40 225 40 225 225 899 40 4.4%

Machako

s

2.8% 513 1,262 699 639 699 623 699 287 2,797 1,549 55.4%

Makueni 0.7% 1,480 118 175 52 175 66 175 127 699 245 35.0%

Mandera 0.0% 2,769 - - - - - - -

Marsabit 0.6% 5,284 85 150 58 150 27 150 319 599 404 67.4%

Meru 1.6% 2,080 362 400 139 400 223 400 1,598 362 22.7%

Migori 2.9% 6,153 1,414 724 781 724 633 724 404 2,897 1,818 62.8%

Mombasa 5.4% 1,764 811 1,348 372 1,348 439 1,348 405 5,394 1,216 22.5%

Murang'a 2.2% 1,766 189 549 549 189 549 196 2,197 385 17.5%

Nairobi 6.4% 764 5,799 1,598 3794 1,598 2005 1,598 1928 6,393 7,727 >100%

Nakuru 1.8% 1,765 1,179 449 608 449 571 449 776 1,798 1,955 >100%

Nandi 1.8% 1,974 74 449 31 449 43 449 208 1,798 282 15.7%

Narok 0.8% 532 4 200 200 4 200 18 799 22 2.8%

Nyamira 0.0% 4,827 40 - 40 - - - 40 -

Nyandarua

1.8% 1,239 530 449 343 449 187 449 228 1,798 758 42.2%

Nyeri 2.1% 58 652 524 394 524 258 524 415 2,098 1,067 50.9%

Samburu 0.6% 1,541 35 150 150 35 150 242 599 277 46.2%

Siaya 5.0% 398 1,157 1,249 626 1,249 531 1,249 406 4,994 1,563 31.3%

Taita

Taveta

1.3% 2,473 57 325 51 325 6 325 1,299 57 4.4%

Tana River

0.1% 692 24 25 24 25 25 71 100 95 95.1%

Tharaka Nithi

1.6% 103 813 400 367 400 446 400 550 1,598 1,363 85.3%

Trans

Nzoia

0.4% 296 159 100 51 100 108 100 383 400 542 >100%

Turkana 2.6% - 1,563 649 968 649 595 649 524 2,597 2,087 80.4%

Uasin Gishu

0.0% - 270 - - 270 - 759 - 1,029 -

Vihiga 0.7% - 169 175 169 175 175 364 699 533 76.2%

Wajir 0.1% - 5 25 25 5 25 100 5 5.0%

West

Pokot

0.3% 413 14 75 75 14 75 300 14 4.7%

Total 100.0% 74,511 43,276 19,328 15,171 19,328 13,615 19,328 14,490 99,885 43,276 43.3%

17


Table 11: Performance data table: Number of clients found to be clinically malnourished INDICATOR TITLE: Number of PLHIV that were nutritionally assessed and found to be clinically undernourished

INDICATOR NUMBER: FN_THER

UNIT: DISAGGREGATE BY: COUNTY Geographic Location Activity Title Date M


Results:

Additional Criteria Baseline

(January

2015)

Results

Achieved

Prior

Periods

Reporting Period

31/Dec/15

Reporting Period

31/Mar/16

Reporting Period 30/Jun/16 FY 2015/16

Target

%

Achievement If other criteria are

important, add lines

for setting targets and

tracking

County %


N N N N N N N N N N

Baringo 1.7% 1,930 578 425 360 425 218 425 301 1,698 879 51.8%

Blank 0.4% 985 575 100 295 80 280 100 400 575 >100%

Bomet 0.9% 1,052 512 225 333 180 179 225 132 899 644 71.6%

Bondo

321 - - - -

-

- - -

Bungoma 0.9% 411 816 225 110 180 706 225 618 899 1,434 >100%

Busia 0.3% 5,124 1,321 75 243 60 1,078 75 684 300 2,005 >100%

Elgeyo

Marakwet

0.4% 886 50 100 8 80 42 100 8 400 58 14.5%

Embu 4.6% 5,481 783 1,149 693 919 90 1,149 386 4,595 1,169 25.4%

Garissa 0.8% 620 147 200 26 160 121 200 132 799 279 34.9%

Homa Bay 4.9% 1,350 2,279 1,224 990 979 1,289 1,224 1,225 4,894 3,504 71.6%

Isiolo 0.6% 2,131 565 150 392 120 173 150 217 599 782 >100%

Kajiado 1.2% 2,669 51 300 51 240 300 95 1,199 146 12.2%

Kakamega 1.9% 2,450 557 474 251 380 306 474 475 1,898 1,032 54.4%

Kericho 2.4% 1,296 223 599 223 479

599

2,397 223 9.3%

Kiambu 2.2% 1,921 2,003 549 919 439 1,084 549 1,322 2,197 3,325 >100%

Kilifi 1.2% 1,048 135 300 135 240

300 201 1,199 336 28.0%

Kirinyaga 1.7% 4,649 1,494 425 763 340 731 425 66 1,698 1,560 91.9%

Kisii 0.9% 1,149 444 225 272 180 172 225 137 899 581 64.6%

Kisumu 4.2% 547 1,971 1,049 836 839 1,135 1,049 578 4,195 2,549 60.8%

Kitui 1.0% 259 463 250 311 200 152 250 94 999 557 55.8%

Kwale 0.5% 1,022 239 125 152 100 87 125 56 499 295 59.1%

Laikipia 0.2% 3,095 196 50 - 40 196 50 93 200 289 >100%

Lamu 0.9% 812 25 225 25 180

225

899 25 2.8%

Machakos 2.8% 593 1,391 699 647 559 744 699 656 2,797 2,047 73.2%

Makueni 0.7% 1,712 482 175 239 140 243 175 504 699 986 >100%

Mandera 0.0% 3,203 - - - -

-

- - -

Marsabit 0.6% 6,112 115 150 69 120 46 150 599 115 19.2%

Meru 1.6% 2,406 412 400 172 320 240 400 314 1,598 726 45.4%

Migori 2.9% 7,117 1,246 724 596 579 650 724 289 2,897 1,535 53.0%

Mombasa 5.4% 2,040 2,200 1,348 1,225 1,079 975 1,348 1,006 5,394 3,206 59.4%

Murang'a 2.2% 2,042 512 549 - 439 512 549 313 2,197 825 37.5%

Nairobi 6.4% 883 7,088 1,598 4,185 1,279 2,903 1,598 2,123 6,393 9,211 >100%

Nakuru 1.8% 2,042 1,437 449 643 360 794 449 1,161 1,798 2,598 >100%

Nandi 1.8% 2,284 1,037 449 672 360 365 449 355 1,798 1,392 77.4%

Narok 0.8% 616 34 200 - 160 34 200 58 799 92 11.5%

Nyamira 0.0% 5,584 25 - 25 - - - 25 -

Nyandarua 1.8% 1,434 452 449 265 360 187 449 171 1,798 623 34.7%

Nyeri 2.1% 68 1,140 524 701 420 439 524 407 2,098 1,547 73.8%

Samburu 0.6% 1,783 165 150 - 120 165 150 220 599 385 64.2%

Siaya 5.0% 460 906 1,249 471 999 435 1,249 388 4,994 1,294 25.9%

Taita Taveta 1.3% 2,860 222 325 34 260 188 325 66 1,299 288 22.2%

Tana River 0.1% 801 12 25 12 20 25 100 12 12.0%

Tharaka

Nithi

1.6% 119 803 400 480 320 323 400 377 1,598 1,180 73.8%

Trans Nzoia 0.4% 343 153 100 84 80 69 100 307 400 460 >100%

Turkana 2.6% - 2,243 649 1,319 519 924 649 724 2,597 2,967 >100%

Uasin Gishu 0.0% - 989 - - - 989 - 976 - 1,965 -

Vihiga 0.7% - 154 175 149 140 5 175 489 699 643 92.0%

Wajir 0.1% - - 25 - 20

25

100 - 0.0%

West Pokot 0.3% 478 7 75 - 60 7 75 50 300 57 19.0%

Total 100% 86,187 38,652 19,328 19,376 15,547 19,276 19,328 17,774 99,885 56,426 56.5%

18


IV. CONSTRAINTS AND OPPORTUNITIES

Staff Constrains: Currently, staffing level for the program stands at 23 Full Time Employees (FTE), with

additional 8 personnel providing administrative support from the shared services. Of the 23 FTE, 5 are

drivers, 7 are nutritionists including the DCOP, 4 are M&E specialist, 2 are in finance, 2 are administrative

staff, 1 agricultural specialist and 2 supply chain specialists that includes the COP. Currently, we have

nutritionist officer and driver located in each focus. The nutrition officers are providing crosscutting

services from nutrition to nutrition-sensitive agriculture programing. The program requires to

demonstrate reduction in stunting in each of the key focus counties of Tharaka Nithi, Kitui, Busia, Samburu

and Marsabit. This requires intensive programming and adequate personnel to provide stewardship in

nutrition-sensitive agriculture programing. Additional personnel are therefore required for the program to effectively deliver on its mandate.

DA1 Form Delay: The program procures RUTF from Insta Products (EPZ), located at the Export

Processing Zone. Procurement originating from the Export Processing Zone requires waiver processing

using the DA1 Form. The program has put in applications for exemption of duty and VAT for RUTF

procured from Insta Products (EPZ) duly accompanied by supporting documents. Beginning January 2016,

the program has put in two DAI Forms for approval, one in October 2015 and the second one in February

2016, but none has received any approval for exception. Due to the exemption approval process taking

long than expected the program has not been able to supply RUTF to the needy clients thereby making it difficult for the program to reach its target.

Facility Reports: Challenges continues to be encountered of receiving commodity and service data from

the facility. These are mainly attributed to GoK staff turnover at facility level due to decentralization of

health services to county level; Inadequate number of HCWs trained to support nutrition assessment and

reporting; Inadequate number and insufficient resources to support CHVs to conduct active case finding,

follow up and provide linkage through community program.

Financial Management: Funds to for the program’s use are held in a common bank account shared by

all projects within the country office. It is therefore not possible to separately determine direct charges

arising from the transactions directly related to the project. Similarly, the interests earned on funds in the bank accounts cannot be verified and separated/isolated for reporting requirements.

Billing to the project is also done from a central pool for both direct and indirect costs. Expenses related

to the indirect costs are not reviewed at project level before being posted to the system. Consequently,

there have been challenges which have arisen in the past, mainly resulting from over billing especially on

administrative related costs and incidences of labor costs billing to the project for staff not in the approved

agreement.

Further due to the centralized billing of shared costs, VAT charges for shared costs are also allocated to

the program proportionately. This approach has posed challenges especially during preparation of the

annual VAT reports. Programs are required to report on VAT status every year and where costs and

expenses are shared, it has been difficult to isolate and track the status for VAT related to shared costs.

V. PERFORMANCE MONITORING

Updates for performance relating to survey base indicators is expected to be updated during the fourth

quarter once surveys for Tharaka and Busia are completed.

During the quarter, the program supported a total of 857 health facilities with data management and

reporting representing an overall reporting rate of 85.7% (857/1000) of target facilities. Overall, there was

increased facility reporting of 29.0% from the preceding quarter (857 vs 609). 383 of these facilities have

been designated as commodity delivery points. To ensure improved facility reporting rates, the program

will continue to engage with CNCs, facility nutrition contact persons and APHIA+ partners’, increase

CME/OJT and joint supervision and sharing of monitoring data reports. The program will also plan to

transition 17 additional high volume facilities into EMR facilities.

Of the to 857 health facilities supported with data management and reporting, 122 submitted their service

data sets and commodity orders electronically. From data already processed during the quarter, a total

of 83,911 clients were assessed with 14,490 of these found to be malnourished being provided with FBF

supplementation during the FY16 Quarter. By the time of compilation of this report, an additional 54,653

client assessments and 15,638 client FBF prescriptions reports are in the process of being entered into the database.

During the quarter, fourteen (14) additional high volume facilities were supported with customized

nutrition electronic software to support data management at facility level. This will enhance timeliness on

data reporting. HCWs who will be responsible for delivery of NACS services were inducted on use of

the nutrition reporting software. However, challenges relating to source documentation errors, high staff

turnover, acceptance of EMR system and existence of parallel partner reporting systems continued to be

observed. During the site visits the following observations were made:

19


• Service and commodity data reporting challenges.

• Some facilities are not willing to share all required datasets especially prescriptions forms.

• Facilities are not consistently submitting assessment data but submit only prescription data.

• Reporting delays.

• Some EMR sites are submitted hardcopies of their data claiming increased workload due to

multiple registers and reporting requirements from other IPs. E.g. Tigoni DH, Lumumba HC,

Nandi Hills DH, Tharaka DH, Muranga DH and Thika Level 5 Hospital.

• Use of standardized quantification units for MOH734 still a challenge.

In mitigation of the above challenges, the program will continue scheduled NACS training and re-

sensitization activities. The program will also work to bridge the knowledge gap through partnership with IPs to support OJT and CME sessions at facility level.

Despite the program having supported successful installation of the nutrition EMR at Memorial AF

Hospital and sensitization of the nutritionist on how to use the system for both service and commodity

data reporting, the facility did not submit service data and commodity orders as expected. The facility

also requested the program to remove personal patient details from their system as this would cause a

security risk. Plans are under way to have all Forces hospitals/clinics report through the Mbagathi

Memorial Hospital. The program will schedule additional training session in the next quarter to induct the newly appointed nutritionist. The program will also target to induct HCWs from other cadres.

To improve data quality, increase data use at facility and county/sub-county levels, the program conducted

a re-sensitization of eight (8) health facilities within Nairobi, Muranga, Kajiado and Nyeri counties primarily

due to staff re-deployment. The facilities were re-sensitized during the quarter included Nyahururu SC

Referral Hospital, Nyeri Provincial General Hospital (PGH), Muriranjas Sub-District Hospital, Makuyu Health Centre, Gatundu DH, KNH, Kajiado County Hospital, Kibera Community HC AMREF.

The customized nutrition EMR system was developed to support management of both service and

commodity functions relating to delivery of NACS at facility level. In addition, the system has the capability

to produce summary data for national service and commodity reporting through DHIS and patient level

data for the yearly forecasting and quantification process for nutrition commodities. The system also

ensures accountability of delivered commodities by rationalizing facility orders based on their reported

consumption.

In support of enhanced provision of NACS at facility level, the program supported electronic nutrition

reporting scale up in 10 high volume facilities. All these facilities received both HW and SW support from

the program. Overall, a total of 15 HCWs comprising of 13 nutritionists, 1 in-charge and 1 nursing officer

were trained on the use of the electronic reporting system. Installation at AIC Litein’s did not proceed as

planned as the base OS was not compatible with the current version of the nutrition EMR. The facility is

in the process of upgrading their in-house OS software’s to allow installation. The program will conduct

site supervision support in collaboration with WRP to explore ways of assisting this and other high volume

facilities within the South Rift region. Facilities scaled up this quarter are: Mbita District Hospital, Homa

Bay District Hospital, Rachuonyo District Hospital, Boro Dispensary, Nyahera Sub District Hospital,

Rabuor Health Centre, Suba District Hospital, Rangwe Sub-District Hospital, Bar Agulu Dispensary, Kaluo

Dispensary.

In an effort to support electronic reporting for 54 focus county MNCH facilities/service points, the

program has finalized database architecture and draft validation rules for MOH 511, CWC register. To

further ensure continuum of client services, the system will be integrated with the current NACS facility

reporting system to support tracking of referral cases. It is expected that pilot testing will be concluded

in FY16 Quarter 4 with deployment commencing once identification of facilities with capacity is completed.

With support from SCNO Dagoretti County, the program conducted site support/supervision visits at

Riruta H.C. and Waithaka H.C. The purpose of this visits was to pilot test a supervision tool jointly

developed by the program and sub-county. The following services, activities and systems were reviewed and challenges and observations documented for further action:

• Type of services provided at the facility (GMP, VAS, MNP, Deworming, IMAM, Maternal

Nutrition, Maternity, TB, HIV, Nutrition)

• Availability of other health system strengthening activities (Scheduled Capacity Building,

quality improvement approaches and Community Linkages/referrals)

• Availability and use of nutrition guidelines and/or job aids

• Stock and Inventory Management

• Dispensing and Storage

• Reporting/ICT support including quality of nutrition reports

Additional support visits to Lea Toto Dagoretti and Kawangware will be scheduled for the next quarter

to review progress of mitigation activities for commodity and reporting challenges observed in the

previous quarter. It was observed that due to lack of adequate human resource capacity at Waithaka HC,

interns had been recruited to run nutrition activities at the CWC and CCC service points; Inadequate

20


equipment for nutrition assessment observed; Service points were not adhering to reporting protocols

in the utilization of bin cards and tally sheets when reporting nutrition commodities; In adequate capacity

for proper follow up of NACS patients due to lack of support for CHVs; Disjointed commodity

management across service points; OTP register and Daily Activity Register for Nutrition Services have

the same MOH number (MOH409); Vitamin A issued at CWC clinic not reported consistently due to

lack of tally sheets; High defaulter rate for ART and NACS/FBP program. Recommends made includes

integrating management of existing nutrition pipelines to ensure central administration; Scale up HIV

testing for all clients at CCC; upgrading of Waithaka HC from satellite to delivery point; Encouraging

CHVs attached to the TB program to also support case finding and follow up for nutrition at community

level.

With the initial version of the nutrition portal complete, the program through NDU has reached out to

county nutrition managers, stakeholders and IPs to provide feedback that will inform final revision. The

second version, to be completed within the next quarter will incorporate interactive and dynamic data

visualization user interfaces. These will allow authorized users to upload, analyze and view data from

routine data sets, surveys and research studies. It is expected that this will allow nutrition health managers to consume this information for informed decision making.

To further support nutrition service reporting at CWC service points, the program is in the process of

finalizing a simple MS Access/SQL based system for data management and reporting. The system will also

be integrated with the facility NACS EMR system to ensure continuity of care through patient monitoring across service points.

VI. PROGRESS ON ENVIRONMENTAL MITIGATION AND MONITORING

The program finalized development of Environmental Review Report (ERR) for the purpose of screening

program food manufacturing activities undertaken by selected Food Manufacturing Factories (Equatorial

Nuts Processors Ltd. and Insta Products (EPZ) Ltd.) as per USAID requirement. Specifically, the program

aimed to identify potential levels of environmental risk due to food manufacturing activities that would

lead to the occurrence of adverse environmental impacts. Arising from this, the program developed and

an Environmental Mitigation and Monitoring Plan (EMMP) to ensure mitigation measures are implemented

to prevent or minimize the occurrence of adverse impacts, to make food manufacturing and storage

activities environmentally-sound. Continuous monitoring during program implementation will hence forth

be undertaken to assess the status and progress of recommended mitigation measures during the program

lifecycle to ensure that timely remedial measures are undertaken. Appropriate indicators and tools have

been developed with sensitization scheduled to be finalized during FY16 Quarter 4.

VII. PROGRESS ON LINKS TO OTHER USAID PROGRAMS

Continuous engagement has been made with all the PREG partners geared towards carrying activities

through collaboration and linkages towards pursuing NHPplus objectives of reducing stunting and

improving nutritional status through nutrition programming in agriculture. During the USAID mission visit,

one opportunity of infusing nutrition messages through training and establishment of the demonstration

garden at the Moyale livestock market came out glaring. The program continues to work with all PREG partners and APHIAplus partners.

A preliminary and ground setting visit by the DCOP mid-June after discussions with the community

revealed that dietary diversity in terms of access, production technologies and consumption of especially

vegetables is a big challenge to the community. Also mentioned were local poultry keeping especially for

mothers and youth. The specific vegetables mentioned include kale, spinach, tomatoes, sweet pepper, hot

pepper and fruits especially melons. These if community trained to raise would go a long way in improving

diets as well as providing some source of income as the current source for the scarce products is Meru county. Already over half acre of land is available downstream of the Moyale market ideal for the activity.

VIII. PROGRESS ON LINKS WITH GOK AGENCIES

The program has been working closely with the NDU, NASCOP, MOE and MOALF. One of the successful

activity accomplished during this reporting period i.e. Malezi bora is attributed to their combined efforts

as program engaged all the mentioned line ministries.

21


1X. SUBSEQUENT QUARTER’S WORK PLAN

Table 12: Planned activities from previous quarter

Planned Actions from Previous Quarter Actual Status this

Quarter

Explanations for Deviations

1.0 Improve access and demand for Quality Nutrition Interventions at Community and Facility levels

1.1 Strengthened leadership, advocacy and policy planning

1.1.1 Support expenses for multi-stakeholder one-day planning

meeting for PROFILES activities with core group

Scope of work developed.

Stakeholder workshop

scheduled for Feb 2017

More time required for planning

and multisector engagement

1.1.11 Participate and support meeting expenses monthly

MIYCN TWG

Attended meeting No meeting expenses supported

1.1.12 Participate and support monthly Food and Nutrition

Linkages TWG

1.1.13 Support meeting expenses and participate in the national

Nutrition commodity pipeline subcommittee

Participated in HIV

commodity security TWG

1.1.14 Support meeting expenses and participate in Quarterly

National Commodity steering committee

Attended tech specs

subcommittee meeting

1.1.15 Support meeting expenses and participate in the Nutrition

Information TWG meetings

1.1.16 Support meeting expenses and provide TA Clinical

Nutrition and Dietetics TWG

Received draft and had

discussions with secretariat

1.1.17 Support meeting expenses for County Nutrition

technical forum (CNTF) meetings in Marsabit, Samburu,

Tharaka-Nithi, Kitui and Busia

No CNTF Scheduled next quarter

1.2 Improved Nutrition service delivery management, coordination and implementation

1.2.1 Support expenses for review of training materials, job aids

and NACS protocols beyond HIV, to include, HiNi, Agri-

Nutrition messages and linkages to livelihood activities

NACS FBP flip chart under

procurement

1.2.2 Facilitate training expenses for Training of USG IP's

including FtF Partners using the revised NACS curriculum

Completed

1.2.3 Conduct training at County level to build capacity of

additional health facilities to provide NACS services

beyond HIV and report service and consumption data

Planned for next quarter

1.2.4 Support upgrade of High volume lower level facilities to

delivery points (desk review no cost activity)

This is continuous activity

1.2.5 Support logistics expenses (lunch & transport) for health

facility HiNi gap assessment in Tharaka, and Samburu

focus counties

HiNi gap assessment

conducted in 2 counties

1.2.11 Support Quarterly OJT and mentorship activities with

sub-county teams in focus counties

Conducted in Nairobi

1.2.17 Support Training of data officers for piloting of Nutrition

monitoring and reporting system into an interoperable

web based system

Training conducted in

Nyanza region

1.2.18 Rollout of web based system to 100 facilities into

electronic nutrition reporting system

1.2.19 Revision of existing Nutrition portal into a robust/scalable

interoperable platform to support KM/KT to support a

multi sectorial nutrition programming

1.2.20 Analyze data for submission of APR PEPFAR Report

1.2.21 Conduct quarterly joint data quality facility assessments

and mentorship visits

1.2.25 Distribute NACS inclusive of HiNi job aid (desktop flip

chart)

1.3 Improve nutrition related behavior

1.3.9 Support expenses for identified National MNCH/

Nutrition activities & county festivals/ shows

Malezi bora activities

conducted

1.3.9.1 MALEZI BORA

Printing of branded materials: t-shirts, caps, banners, leso,

posters

Done

Support planning meeting for Malezi Bora at sub-county

level

Done

Conduct social mobilization at community level (5-day

maximum)

Done

Facilitate cooking demonstration expenses at the

community & Malezi Bora Day (ECDE/CU)

Done

Malezi bora Post review meeting at sub county level

1.5 Increased knowledge and skills of health care workers (HCWs) in nutrition

1.5.4 Support NACS training expenses for IPs and MOH Done

2.0 Strengthened Nutrition Commodity Management

2.1 Improved production, supply and distribution of nutrition commodities

2.1.1 Facilitate procurement and distribution of 424MT (23,556

Cartons) of FBF comprising:

FBF Adults: 254MT (14,133 cartons)

FBF Children: 127.2 MT (7,067 cartons)

FBF Pregnant/postpartum: 42.4 MT (2,356 cartons)

Done

2.1.2 Print Data Collection/Reporting tools

MOH 407A: 1,000

MOH 407B: 1,000

On course

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MOH 733B, 900

MOH 734B: 900 and Appointment Cards: 100,000

2.1.3 Print 2,000 copies of NACS/FBP Desktop job aids On course

2.1.4 Distribute job aids and data collection/reporting tools Not done Awaiting finalization of

procurement process

2.1.5 Procure and distribute anthropometric equipment for

MCH service point in level 4 facilities

Sourcing for quotations -

done

Evaluation of received

quotations - on-going;

2.1.6 Participate and contribute to development of

Quantification plan for Nutrition Sector

Not done Postponed to coming quarter by

MOH

2.1.7 Participate and contribute to development of

procurement plan for Nutrition Sector

Not done Postponed to coming quarter by

MOH

2.1.8 Roll-out of Electronic CDRR to all nutrition service points On course – xxx number of

facilities pretesting the e-

CDRR

2.1.9 Contribute to the Monthly NHPplus Supply Chain

Information workbook for NDU/NASCOP

Done

2.1.10 Provide service and commodity data for the monthly

Two-page summary for NDU pipeline subcommittee &

NASCOP

Done

2.1.11 Participate and/or support in the nutritional commodity

security technical working group

Done

2.1.12 Conduct facility monitoring visits Done

2.2 Improved quality and safety of food commodities and agricultural products

2.2.1 Conduct Supplier Quality Audit for Equatorial Nut

Processors and Insta Products

Done Summary of findings to be shared

in the coming quarter

2.2.2 Conduct post procurement batch testing Sampling completed

Testing/Results to be Done

in the coming quarter

2.3 Strengthened sustainability and innovation in nutrition commodity development and management

2.3.2 Track proportion of locally sourced agricultural raw

materials used in FBF and RUTF procured through

NHPplus

Done

3.0 Improved food and nutrition security

3.1 Increased market access and consumption of diverse and quality foods

3.1.1 Conduct consultative meetings with focus counties Done in Busia MOALF and

MOH staff during FtF

evaluation visit

Meeting for Kitui scheduled 4th

quarter

3.1.2 Conduct inception meetings in the FtF focus counties with

multi-sectoral stakeholders and partners at county & sub-

county levels

Consultative discussions

held with multi-sectoral

stakeholders and partners

on agri-nutrition during

national meetings

County based meetings to

continue quarter 4

3.1.3 Conduct baseline/ Mid-term assessment on multi-sectoral

nutrition programing (health, agriculture, WASH and

nutrition) 5 focus counties i.e. Zones of influence

(including SBCC, food varieties, consumption patterns,

nutrition status, social economic status, demographics)

Done for Samburu Quarter 4 planned for Marsabit,

Tharaka Nithi and Kitui

Training of enumerators Done for Samburu To be trained for the other

counties during survey

3.1.4 Identification of zones of influence Done

3.1.5 Conduct Identification of community groups (women,

youth, Mother to mother support groups, farmer groups)

Done for Busia, Tharaka

Nithi, Kitui, Samburu

Process to continue quarter 4

3.1.6 Conduct contextualization workshop for Applied Basic

Agri-Nutrition Manual (KHCP Manual) for Busia, Kitui,

Marsabit, Samburu & Tharaka Nithi

Process initiated 2-day technical workshop planned

for quarter 4

3.1.7 Conduct county Validation workshops for the

contextualized draft Agri-Nutrition Manual

Not done Awaiting manual

3.1.8 Conduct meetings to develop contextualized recipe

guides: e.g., maternal nutrition, complementary feeding

(Vit. A, iron rich foods, other nutrient dense foods)

Tech team constituted for

Busia

Cassava recipe guide for Busia and

Kitui to support printing

3.1.9 Conduct TOT Trainings for sub-county (FEWs, CHEWs,

DICECEs, community resource persons) on use and

adoption of appropriate technologies e.g., kitchen

gardens, food preservation, water harvesting to increase

household food production and consumption (ref 1.5 for

MSN trainers guide)

Not done To be quarter 4 all counties

3.1.10 Define a demonstration kit for the focus counties based

on identified appropriate technologies

Not Done To be done during the MSN

training

3.1.11 Conduct demonstrations to showcase the application of

simple appropriate technologies for increasing household

food production, consumption of iron, vit. A rich food e.g.,

kitchen gardens, cooking demos, water harvesting to community groups

Done in 2 counties

Cooking demos done

Gardens planned for quarter 4 in

the 3 counties

3.1.12 Train CHEWS/PHTs, ECDE teachers, and FEWS on

Maternal nutrition, IYCF, dietary diversity (Iron & Vit A)

and WASH, key messages for social mobilization

Not done To be done by ToTs from MSNS

training

3.1.13 Sensitize NDMA field monitors, CHCs, CHVs on

Maternal nutrition, IYCF, dietary diversity (Iron & Vit A)

and WASH, key messages for social mobilization

Not done To be done by ToTs from MSNS

training

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3.1.14 Support community based resource persons (FEWs,

CHEWs, DICECEs,) to disseminate key agri-nutrition and

WASH messages at sub-county level platforms e.g. Farmer

Field schools, community units, chief barazas, MtMSGs, 4K

clubs

Done To continue in all counties

3.2 Improved Resilience

3.2.1 Support workshop expenses for capacity building to

conduct SMART surveys for 2 sub counties in selected

focus counties

Done for Samburu Other counties planned quarter 4

3.2.2 Support SMART survey expenses (transport & stationery)

every 2 years in Marsabit, Samburu & Kitui

Done Other years planned

3.2.3 Support dissemination of survey results (Baseline/ Mid-

term)

Done Awaits survey results

3.2.4 Map existing food security, livelihood and economic

support in the focus counties/ zones of influence (desk

review)

Done Busia to be done quarter 4

3.2.5 Support consultative meeting expenses to define

contextualized food security, livelihood and economic

support package

Not done To be done alongside MSNS

training

3.2.6 Collect and collate data on referral cases from 2 facilities

per ward in 2 sub-counties per county

Done Data got for all counties and 144

in-patient referral cases identified,

process on-going

3.2.8 Support group meeting expenses for linked vulnerable

households to economic strengthening activities

Not done Working with NDMA

3.2.9 Support logistics expenses to identify vulnerable

children/adults through NDMA sentinel site assessment

(drought early warning & monitoring household

questionnaire or Household Hunger score) tool

Done for Samburu Other counties data not compiled

3.2.12 Support training expenses for (change agents) DICECEs,

Gender & Social services agents and NDMA officers

dealing with OVC, Older persons, People with disability

cash transfers on key MIYCN messages for social safety

net programs

Not done Planned for quarter 4 after NDMA

training

3.2.13 Support logistics expenses for DICECEs, Gender social

services, NDMA officers, FtF IPs to conduct community

forums on how to effective use of cash transfers for

improved nutrition


training

3.2.14 Support workshop expenses to develop food production

and consumption pamphlet based on cash transfer amount

to inform vulnerable households


training

3.2.15 Facilitate expenses for a TOT at sub-county level on

community managed disaster risk reduction

Not done Community level CMDRR planned

for Kitui and Tharaka Nithi quarter

4

3.2.16 Support meeting expenses conduct participatory disaster

risk reduction assessment at ward level



4

3.2.17 Support meeting expenses for Dissemination of Disaster

Risk Reduction plans at sub-county, ward levels



4

3.2.18 Support expenses to train NDMA early warning system

field monitors on Nutrition screening & referral using

MOH 100

Done 39 staff trained others planned for

quarter 4

3.2.19 Support printing of seasonal planner Not done Waiting for season

3.2.20 Support the FEWs to conduct dissemination meetings of

seasonal planner at the ward level

Not done Waiting for season

3.2.21 Support meeting expenses for PREG Monthly consultative

forum

Rotational Planned in October

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X. FINANCIAL INFORMATION

25


XI: ANNEXES & ATTACHMENTS:

ANNEXE I: PERFORMANCE MONITORING Type Indicator Name FY16

Target Oct-Dec 2015 Jan-Mar 2016 Apr-June 2016 FY 2 %

Achievement

as of June 2016


PMP # of mechanisms created to facilitate coordination on an ongoing basis as a

result of USG Assistance (e.g. forum, working group, MOU, shared plans,

associations, budgeting work planning, projects) Note that it is important to identify best practices as they emerge. (NICC, NICC-TWG, NICC-TWG

Subcommittees, CNTF)

10 2 0 2 4 2 6 6 10 >100%

PMP # of people trained. Mentored, provided TA at National Level. 10 0 0 2 0 6 0 8 0 -

PMP Number of policies affected by USG supported efforts and advocacy campaigns)

0 0 0 1 1 0 0 1 1 100.0%

PPR Number of health facilities with established capacity to manage acute

undernutrition (S)

54 0 0 54 0 54 56 54 56 >100%

PMP % of facilities submitting timely, complete and accurate information - 92.0% 67.0% 38.2% 67.0% 62.8% 67.0% 88.4% 92.0% 88.4% 96.1%

PPR Number of people trained in child health and nutrition through USG-supported programs

215 54 14 54 227 54 113 215 354 >100%

PMP Percentage of PLHIV who are nutritionally assessed via anthropometric

measurement

100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

PEPFAR Proportion of clinically undernourished PLHIV who received therapeutic or

supplementary food 78.9% 48.1% 83.2% 48.1% 78.5% 48.1% 58.1% 78.9 58.1 73.6%

PPR Number of children under 5 who received Vitamin A from USG supported programs

72,387 18,097 0 18,097 6,866 18,097 56,691 54,291 63,557 >100%

PPR Number of children under five who are wasted (WHZ) 3,747 937 4,508 937 7,848 937 0 2,811 12,356 >100%

PPR Number of children under five who are Underweight (WAZ) 8,033 2,008 80 2,008 104 2,008 0 6,024 184 3.1%

PMP # of Advocacy guides on IYCF developed 1 0 0 0 0 1 0 1 0 -

Contract # of communication materials updated and distributed for HCWs, CHVs

and mass mobilization;

19,320 4,830 0 4,830 0 4,830 0 14,490 0 -

PMP % of county officials trained who demonstrate increased knowledge in training as result of USG support

1 0 0 1 0 0 0 1 0 -

PEPFAR The percentage of storage sites where commodities are stored according to

plan, by level in supply system.

350 0 0 0 0 0 0 350 400 >100%

PMP Numbers of Policies/Regulations/Administrative Procedures in each of the following stages of development as a result of USG assistance

1 0 0 1 1 0 0 1 1 100%

PMP Number of private enterprises producer organizations, water users’

associations, women’s groups, trade and business associations and community based organizations [C0Bs] that applied improved technologies or management practices as a result of USG assistance

1 0 1 0 0 0 0 0 1 -

PMP # of people trained. Mentored, provided TA at National/County Level on SCALE,

125 31 31 8 0 0 0 125 31 24.8%

Contract % change of cost for nutrition commodities 2% 0 0 0 0 0 0 0 0 -

26


Contract # of active health facilities reporting stock outs for FBF and RUTF in the preceding six months)

<20% <20% <20% <20% <20% <20% <20% <20% <20% 100.0%

Contract # of mechanisms created to facilitate coordination on an ongoing basis as a result of USG Assistance

2 1 0 1 0 0 2 2 2 100.0%

Contract Number of facilities implementing comprehensive NACS at health facilities (beyond CCC/ART sites)

400 100 0 100 150 100 161 400 161 40.3%

Contract Number of standardized SBC nutrition materials distributed (and revised if

necessary) to community health and agricultural extension workers supported by USAID IPs

33,324 4,830 0 9,498 0 0 33,324 14,328 0 -

Contract # of mechanisms created to facilitate coordination on an ongoing basis as a

result of USG Assistance (e.g. forum, working group, MOU, shared plans, associations, budgeting work planning, projects) Note that it is important to

identify best practices as they emerge. (counties using SCALE)

3 0 0 1 0 1 0 2 0 -

PMP # of mechanisms created to facilitate coordination on an ongoing basis as a result of USG Assistance (e.g. forum, working group, MOU, shared plans,

associations, budgeting work planning, projects) Note that it is important to identify best practices as they emerge (Linkages with FtF partners)

2 0 0 0 0 1 1 1 1 50.0%

Kitui -

T. Nithi -

Samburu 1 1 1 1 100%

Marsabit -

Busia -

PPR Number of children < 5 years reached by USG supported nutrition

programs

90,484 22,621 3,770 22,621 12,409 22,621 76,752 67,863 92,931 >100%

PPR Prevalence of wasted children under five years of age TBD 0 0 0 0 0 0 0 0 -

PPR Prevalence of underweight women TBD 0 0 0 0 0 0 0 0 - Kitui 0 0 -

T. Nithi 0 0 -

Samburu 0 0 0 -

Marsabit 0 0 -

Busia 0 0 -

PPR Prevalence of children 6-23 months receiving a minimum acceptable diet

(RiA)

TBD 0 0 0 0 0 0 0 0 - Kitui 0 0 -

T. Nithi 0 0 -

Samburu 0 0 0 -

Marsabit 0 0 -

Busia 0 0 -

PPR Prevalence of households with moderate or severe hunger (RiA) TBD 0 0 0 0 0 0 0 0 -

PPR Prevalence of exclusive breastfeeding of children under six months of age TBD 0 0 0 0 0 0 0 0 -

PPR Number of people implementing risk-reducing practices/actions to improve resilience to climate change as a result of USG assistance (S)

14,001 0 0 4,667 0 4,667 0 9,334 0 -

PMP # of people trained. Mentored, provided TA at National/County Level. 2 0 0 1 0 0 0 1 0 -

27


PMP # of tools/templates/models provided by target institutions in order to facilitate devolution at the local level as a result of USG assistance

4,500 0 0 1,500 0 1,500 0 3,000 0 -

Contract Number of additional food manufacturers in the private sector meeting quality standards

1 0 0 1 0 1 1 2 1 50.0%

Contract % of nutrition commodity distribution (procured by NHPplus) managed by KEMSA

>90% 0 0 0 0 0 >90% 0 - -

Contract # of mechanisms created to facilitate coordination on an ongoing basis as a

result of USG Assistance (e.g. forum, working group, MOU, shared plans, associations, budgeting work planning, projects) Note that it is important to identify best practices as they emerge (joint work plans addressing:

promoting nutrition at HH level, increasing HH income for vulnerable

farmers, and strengthening linkages between vulnerable farmers and market actors/private sector)

2 0 0 0 0 0 2 0 2 -

Contract % of FTF partners trained and provided TA on inclusion of poor farmers in value chain tool

TBD 0 0 0 0 0 0 0 0 -

Contract # of FtF partners provided technical assistance to adopt existing agri-nutrition tools to include HH production and consumption of nutritious foods

TBD 0 0 0 0 0 0 0 0 -

PMP = NHPplus Performance Monitoring Plan; PPR = USAID Program Performance Reporting: Contract = NHPplus Contractual Paid up indicator

28


Annex II: Schedule of Future Events

This is a chronological list of significant events planned in the coming quarter that will contribute to

accomplishment of the activity’s indicators, such as trainings, opening ceremonies, conferences, etc.

This is not a place to list administration tasks, e.g., hiring of staff.

DATE LOCATION ACTIVITY

August Nairobi

Meeting to establish multi-stakeholder core working group

for PROFILES Kenya coordinated by Ministry of Devolution

and Planning – Food and Nutrition Planning Unit

August Nairobi - KSG Facilitate tuition fees for Busia CNC and NDU officer to

attend senior management course

September Nairobi PROFILES core group meeting

August Nairobi National World Breast Feeding week exhibition

August Nairobi Agri Nutrition TWG meeting

Aug Nairobi Finalization of MIYCN counselling card (MIYCN TWG)

August Nairobi NACS ToT for Nairobi county / Afya Jijini

Sept Nairobi NACS Nairobi Sub county training

Jul – Sept Coast, Transmara, Nakuru NACS Orientation coast region, Transmara, APHIA Rift

Jul – Aug Nairobi Development of Agri Nutrition Training Manual

Jul – Sept Nairobi Nutrition symposium/ conference planning meetings and

venue lockdown

July, August Busia, Tharaka Nithi, Kitui,

Marsabit

Training of ToTs on Multi-Sectoral Agri-Nutrition

Strategies

July-August-September Busia, Tharaka Nithi, Kitui,

Marsabit SMART Survey

25th to 29th July 2016 Nakuru Quantification for Nutrition Commodities workshop

29th July 2016 Busia - County Offices Busia County Nutrition Technical Forum (Tea and Lunch)

August Nairobi/Counties Workshop to finalize agri-nutrition modules

8th to 11th August Mwingi/Kitui NACS training

15th – 16th August 2016 Busia NACS Training (Conference and accommodation)

15th to 18th August Kitui Development of Recipe manual (small conference)

17th – 19th August 2016 Busia MIYCN Training (Conference and Accommodation)

18th to 22ndAugust Kitui IMAM training

25th to 27th August Kitui IFAS training

29th August – 1st

September Busia

Contextualization of recipe manual (Conference and

Accommodation)

September Nairobi Training of partners on nutrition sensitive interventions

19th to 23rd Sep Kitui MIYCN training.

5th – 7th September 2016 Busia IFAS TOT Training (Conference and Accommodation)

Documents

USAID KENYA NUTRITION AND HEALTH …pdf.usaid.gov/pdf_docs/PA00MN97.pdfUSAID KENYA NUTRITION AND HEALTH PROGRAM plus FY 2016 Q3 PROGRESS REPORT APRIL 1–JUNE 30, 2016 Award No: AID-615-H-15-00001