EVALUATION OF CAFOD’S

ORGANIZATIONAL RESPONSE TO NIGER’S

2005 FOOD CRISIS

SARAH L. MCKUNE, MPH MAY 18, 2007

2

ACKNOWLEDGEMENTS

It is the hope of the author that this report fully and accurately reflects the efforts, commitment, and achievements of all parties involved in CAFOD’s response to the 2005 food and nutritional crisis in Niger. The author would like to thank staff members at CRS Niger, HKI Niger, CADEV and IRN who went out of their way to provide organizational information, first hand understanding of field activities, and logistical support in Niger - namely Jasmine Bates, Ali Abdoulaye, Hamani Harouna, Aissa Doro, Raymond Yoro, Ouedrago Housseini, and Dr. Idrissa Maiga Mahamadou. Additional thanks are extended to the entire staff at each partner office in Niger for detailed attention (like recovering lost luggage!) and infinite flexibility during our visit. The author expresses great gratitude to the nutritional staff that operate and support feeding centers throughout Niger. In conjunction with the communities and beneficiaries of various partner projects, these individuals provided key insight into the functioning, past and future, of nutritional programs in Niger. Their availability, enthusiasm, and candid nature provided seminal information to this evaluation and will undoubtedly contribute to improving future efforts throughout the country.

"A hungry person is an angry person. It is in all our interests to take away the cause of

this anger." – President Olusegun Obasanjo, Nigeria

3

TABLE OF CONTENTS

ACKNOWLEDGEMENTS................................................................................................ 2

ACRONYMS AND ABBREVIATIONS........................................................................... 4

1. EXECUTIVE SUMMARY ......................................................................................... 5

2. OBJECTIVES.............................................................................................................. 7

3. INTRODUCTION ....................................................................................................... 8

3.1 NIGER SITUATION ANALYSIS ................................................................................... 8 3.2 CAFOD ORGANIZATIONAL RESPONSE................................................................. 10

4. FINDINGS................................................................................................................. 12

4.1 IMPLEMENTING PARTNER RESPONSE....................................................... 12 4.1.1 Relevance/Appropriateness............................................................................ 12 4.1.2 Connectedness................................................................................................ 14 4.1.3 Coherence....................................................................................................... 16 4.1.4 Coverage ........................................................................................................ 19 4.1.5 Efficiency........................................................................................................ 20 4.1.6 Effectiveness ................................................................................................... 22 4.1.7 Impact............................................................................................................. 24

4.2 CAFOD ORGANIZATIONAL RESPONSE ...................................................... 26 4.2.1 Strategic Fit.................................................................................................... 26 4.2.2 Partner/Project Selection............................................................................... 28 4.2.3 Program Support............................................................................................ 30

5. CONCLUSIONS........................................................................................................ 32

5.1 IMPLEMENTING PARTNER RESPONSE .................................................................... 32 5.2 CAFOD ORGANIZATIONAL RESPONSE................................................................. 32

6. RECOMMENDATIONS........................................................................................... 34

6.1 IMPLEMENTING PARTNER RESPONSE .................................................................... 34 6.2 CAFOD ORGANIZATIONAL RESPONSE................................................................. 35

APPENDIX I: TERMS OF REFERENCE....................................................................... 36

APPENDIX II: TIMETABLE OF FIELDWORK IN NIGER ......................................... 42

APPENDIX III: PARTNER SPECIFIC FEEDBACK ..................................................... 45

III.1 CRS/HKI FEEDBACK FROM CAFOD EVALUATION .............................................. 45 III.2 CADEV FEEDBACK FROM CAFOD EVALUATION ................................................ 49 III.3 IRN FEEDBACK FROM CAFOD EVALUATION ....................................................... 52

4

ACRONYMS AND ABBREVIATIONS

AIDS Acquired Immune Deficiency Syndrome ARV Antiretroviral BALD Bureau d’Animation et de Liaison pour le Développement BEG Bubbling Emergencies Group CAFOD Catholic Agency for Overseas Development (Caritas England/Wales) CEG Corporate Emergency Group CRENAM Centre de récupération nutritionnelle ambulatoire pour modérés (Nutritional recuperation center for moderately malnourished) CRENAS Centre de récupération nutritionnelle ambulatoire pour sévères (Nutritional recuperation center for severely malnourished) CRENI Centre de récupération nutritionnelle intensive (Intensive nutritional recuperation center) CSI Centre de Santé Intégré (Integrated Health Center) CSD Comite Solidarité Développement CRS Catholic Relief Services CTC Community-based Therapeutic Care DAC Development Assistance Committee DEC Disasters Emergency Committee FFW Food-for-Work GAM Global Acute Malnutrition GAS Grant Appraisal Summary GON Government of Niger GPB British Pound HIV Human Immunodeficiency Virus HKI Helen Keller International IEC Information, Education, and Communication IFAD Institute for Agricultural Development IRN Islamic Relief Niger NGO Non-governmental organization NNP National Nutritional Protocol (Niger’s) PHRAN Projet de Réhabilitation des Handicapés et aux Aveugles du Niger SCIAF Scottish Catholic International Aid Fund SOA Special Operation Appeal TB Tuberculosis TOR Terms of Reference UN United Nations UNDP United Nations Development Programme UNICEF United Nations International Children’s Education Fund USAID United States Agency for International Development WAGL West Africa/Great Lakes WFP World Food Program WHO World Health Organisation

5

1. EXECUTIVE SUMMARY

Niger, a landlocked, Sahelian country consistently ranked among the poorest countries in the world, suffered tremendously during the 2004/2005 regional food crisis and the nutritional crisis which followed. Despite early warnings and appeal for assistance by the World Food Program (WFP) and the Nigerien government in November 2004, International attention was not directed towards the crisis in Niger until after a United Nations (UN) Flash Appeal, launched in May 2005, and subsequent media attention. In 2005, the Catholic Agency for Overseas Development (CAFOD), whose vision is of a world “free from poverty and injustice where all have access to food, clean water, shelter, and security; to a livelihood, health and education . . .”, had no history or presence in Niger. Working through existing organizational mechanisms, CAFOD decided in June 2005 that it would financially support partnering agencies in Niger with funds from the General Emergency Budget. Soon thereafter, an unprecedented outpouring of unsolicited private donations poured into CAFOD, and the organization decided to increase financial and technical support to Niger through additional support of implementing partners. The decision to intervene in Niger through implementing partners was an appropriate and effective decision that increased the overall efficiency and impact of CAFOD’s efforts. CAFOD spoke with a number of potential partners, including some with organizational histories of partnership with CAFOD, conducted a field visit for further investigation into potential partners, and ultimately selected three partners with which to work: Catholic Relief Services (CRS), Caritas Development Niger (CADEV), and Islamic Relief Niger (IRN). Each of the three implementing partners had ongoing food security and emergency relief operations underway in Niger at the time of initial partnership. The success of implementing partner programs provides supporting evidence that CAFOD made a good organizational decision to engage in Niger in 2005. Examination of Development Assistance Committee (DAC) criteria highlights programmatic strengths and weaknesses among partners and in CAFOD’s response. Since July 2005, CAFOD funded programs have admitted 110,000 children into nutritional centers and have achieved a 92% recovery rate (among both the moderately and severely malnourished). Additionally, CAFOD funded water and sanitation efforts have increased access within the target population to an adequate supply of safe water by drilling 3 new boreholes and rehabilitating 11 existing non-functional water points. CAFOD funded efforts have complemented an array of food security and broader development efforts concurrently undertaken by partnering agencies. These efforts include food-for-work (FFW), rehabilitation of soil, reconstitution of community grain banks, free food distribution, seed fairs, off-season gardening, livestock distribution, and free primary healthcare. Overall, CAFOD support to implementing partners has been good. Partners have lauded CAFOD as a funding agency, citing timeliness, responsiveness and availability as strengths of the donor organization. However, DAC findings indicate that CAFOD may improve its partner support by focusing on the following areas: standardization of partner reported nutritional data; delineation of CAFOD funded activities as a portion of larger scale efforts; facilitation of inter-partner collaboration and information sharing; and

6

explicit prioritization of CAFOD strategic areas (HIV/AIDS, gender, environmental sustainability, child protection, and capacity building). Evaluator recommendations target both improved implementing partner response and CAFOD’s organizational response: • CAFOD should ensure that targeted vulnerable populations, including lactating and

pregnant women and people living with HIV/AIDS (PLWHA), are included in nutritional programs, as outlined in the NNP.

• CAFOD should facilitate increased communication and collaboration among partners. • CAFOD should ensure its strategic vision of environmental sustainability is

understood and adopted by implementing partners. • CAFOD should support implementing partners in adherence to the National

Nutritional Protocol (NNP). • CAFOD should advocate rectifying discrepancies between the NNP and a true CTC

approach. • CAFOD should conduct a formal assessment to determine nutritional program

coverage. • The CAFOD Humanitarian Officer should receive monthly nutritional data sent to

UNICEF (including admissions, recoveries, deaths, transfers, and abandons, reported by CRENAM, CRENAS, and CRENI).

• CAFOD should hold partners accountable for funds allocated under contract, except where mutual written agreement (email acceptable) has determined that funds will be spent otherwise.

• CAFOD should continue to support IRN and CRS/HKI and CADEV toward integration with Government health facilities.

• CAFOD should invest in longer-term support to CADEV, with a focus on increasing CSD capacity in their respective catchment areas.

• CAFOD should designate Niger a priority country. • CAFOD should continue funding through 2007, incorporating partner-specific

evaluation feedback. • Future CAFOD funded programming in Niger should be targeted towards improved

water and sanitation, public health, and nutritional screening and treatment. • CAFOD should identify and provide technical support to each implementing partner. • CAFOD should consider having one staff person could be based in Niger. • CAFOD should ensure all partners have a clear understanding of its organizational

mission, vision, and strategic interests. • CAFOD should articulate clearly its project goals, objectives and exit strategy to

partners and/or beneficiaries before the implementation of programs. • CAFOD should remain engaged in the international discourse on how best to address

malnutrition as a chronic emergency. • CAFOD should review the benefits a regional response in the Sahel versus a Niger

specific response.

7

2. OBJECTIVES

In response to the 2005 food crisis in Niger, the CAFOD has provided seven (7) grants to three (3) partnering agencies operating within Niger: CRS, CADEV and IRN. This evaluation aims to assess CAFOD’s overall response to the Niger food crisis, providing essential accountability to stakeholders and capturing lessons learned for future endeavors of CAFOD and other international aid organizations. As outlined in the Evaluation Terms of Reference (see Appendix I), this report assesses CAFOD’s management response process through close examination of the following elements:

• CAFOD priorities, competence, and capacity at the time of intervention; • CAFOD’s rationale to prioritize support to particular projects and partners; and • CAFOD’s level of monitoring, assessment of partner performance and strategies,

follow-up, and support provided by CAFOD during the response. The evaluation process included an assessment of partner performance through consideration of the Development Assistance Committee (DAC) criteria (appropriateness, connectedness, coherence, coverage, efficiency, effectiveness, and impact). These criteria helped to identify the successes and limitations of the field programs and contributed to a thorough understanding and assessment of CAFOD’s overall response. The evaluation was conducted through a mixed-method approach, which included the following elements:

• Informal interviews with CAFOD staff in London; • Review of project documents, including Special Operation Appeals (SOA), Grant

Appraisal Summaries (GAS), partner reports, written correspondences, and other archives;

• Key informant interviews with implementing partner agencies, in Niamey and the field;

• Qualitative data collection (focus groups, interviews) with program beneficiaries; • Site visits for observation of ongoing programs; • Semi-structured interviews with health agents, project staff, local authorities,

donors, partners, and beneficiaries; and • Review of documents and primary/secondary data collected in the field.

Fieldwork for the evaluation was conducted from April 21st – May 7th, 2007 by Sarah McKune, an independent global health consultant. The timetable of fieldwork is presented in Appendix II. The evaluation was funded by CAFOD. The views expressed herein are those of the consultant and do not represent any official view of CAFOD or its partnering agencies.

8

3. INTRODUCTION

3.1 Niger situation analysis

A landlocked country situated in the heart of the African Sahel, Niger is categorized as the poorest country in the world, ranking 177 among 177 countries by United Nation’s Development Program’s (UNDP) Human Development Index1. Driving Niger’s status as the poorest country in the world is a dire health situation throughout the country, exacerbated by widespread, absolute poverty. 61.4% of Nigeriens are living under the international poverty line, surviving on less than $1 a day, while 85.3% survive on less than $2 a day1. Life expectancy at birth for a child born between 2000-2005 is 44.3 years1. This expectancy is lower for women, due in large part to extremely high fertility (7.9 children per woman) and an associated high maternal mortality ratio of 1600 maternal deaths per 100,000 live births 1. Lifetime risk of dying a maternal death in Niger is 1 in 72. Malnutrition rates from November 2006 indicate high prevalence of both chronic and acute malnutrition.3 Global chronic malnutrition (GCM, height for age) ranged from 18% in Niamey to 52.4% in Zinder, for a national rate of 43.8%. Global acute malnutrition (GAM, weight for height) ranged from 6.8% in Maradi to 12.5% in Agadez, Dosso, and Tahoua. See the table below for detail.

Region n GAM SAM n GCM SCM

Agadez 785 12.5 1.5 786 41.2 17.9

Diffa 773 10.1 0.9 773 46.4 20.9

Dosso 975 12.5 2.4 964 47.8 20.7

Maradi 1268 6.8 0.6 1262 57 29.8

Tahoua 1647 12.5 1.1 1647 37.2 14.3

Tillaberi 1345 11.2 1.9 1341 32.7 10.1

Zinder 1297 9.7 1.7 1289 52.4 27.1

Niamey 611 9.2 0.5 610 18 4.4

Total 8701 10.3 1.4 8672 43.8 19.5

More than 50% of the population lack access to appropriate water sources and health services1. As a result, existing public health programs and infrastructure, which are under-funded, under-staffed and under-stocked, are serving beyond their capacity, sacrificing their quality and coverage 4. In 2005, Niger was one of the counties worst affected by the regional food crisis and the emergency nutritional situation that followed. Characterized by high rates of malnutrition, elevated market prices, and reduced purchasing power, the crisis in Niger had roots in structural causes, such as widespread poverty, rapid population growth,

1 UNDP Human Development Report 2005 2 Americans for UNFPA, Niger's Famine Increases Miscarriages and Premature Births 3 Enquête Nutrition et survie des enfants de 6 à 59 mois au Niger, January 2007, GoN, WFP, and UNICEF 4 Mousseau, F. Sahel: A Prisoner of Starvation? Study of the 2005 food crisis in Niger.

October 2006.

9

inadequate public health infrastructure, high rates of chronic malnutrition, and cyclically high rates of acute malnutrition 5. These ongoing realities were compounded by locust infestation, pockets of severe drought, and subsequent delays by the Government of Niger (GoN) and humanitarian aid community to respond appropriately. An already precariously positioned Niger was pushed into a crisis situation. Much debate has surrounded the events that led to what is widely agreed to have been an emergency situation by September 2005. Many agencies believe the emergency should not have happened and that it’s magnitude and scale were affected by inaccurate analysis of events leading up to the crisis. Additionally, it is widely agreed that the delayed and poorly managed response by the international aid community further aggravated the deteriorating situation, pushing the country into a national state of emergency 3. The situation of Niger in 2005 clearly merited a humanitarian emergency response; with a GAM rate above the 15.0% threshold for an emergency, aid organizations acted to improve access to food and relieve suffering from malnutrition. Niger’s GAM rate is now down to just above 10%. There is currently good market availability and relatively stable prices for major grain in Niger6. Grain prices are beginning to increase, as is expected this time of year. However, the increase may be further driven by the GoN’s initiation of a grain procurement program implemented to increase national food security reserves (down to 200 MT as of January 2007). The preliminary findings by the joint GoN/WFP/FAO/ UNICEF/FEWSNET household vulnerability assessment conducted in November 2006 indicate that nearly 30 percent of Nigerien households are food insecure. Nine percent of whom (1,100,000 individuals) are classified as severely food insecure. The departments with the highest proportions of food insecure households are Tillaberi (62 percent of local households), Ouallam (55 percent), Tahoua (51 percent), Tanout (50 percent), Loga (50 percent), Keita (48 percent) and Bouza (44 percent). UNICEF warns that despite recent success in reducing Niger’s GAM from 15.3% in November 2005 to 10.3% in November 2006, one-fifth of the 2.3 million children in the country die every year, almost 60 percent of them from malnutrition-related problems7. UNICEF and its partners expect to treat 300,000 malnourished children in 2007, about 73% as many as were treated in 2006 8. There is ongoing debate about what action high rates of malnutrition mandates from aid organizations. An IRIN article from May 2007 suggests that organizational responses to high rates of chronic malnutrition fall between development and humanitarian aid, thus falling between the mandates of some organizations7. There is indication that at least

5 CARE, CRS, World Vision, and Save the Children (UK), Joint Evaluation of the

Humanitarian Response to the 2005 Food Crisis, November 2005 6 Niger Monthly Food Security Update, FEWSNET/USAID/WFP, April 11, 2007 7 Revue de Presse de l’Afrique de l’Ouest, semaine 20 au 27 avril 2007, Nations Unies 8 Malnutrition challenges child survival in Niger, despite recent gains, UNICEF Newsline, accessed May 15, 2007

10

some donors want to focus on poverty reduction, with the expectation that declining malnutrition rates will naturally follow.

3.2 CAFOD Organizational Response

In October 2004, the Nigerien government and the World Food Program (WFP) appealed for international support. By February 2005, the appeal was only 10% funded 9. There is no documented attention to Niger by CAFOD until after May 2005, when the UN launched a Flash Appeal, asking for $US 16,100,000 for support in Niger. At the time, CAFOD had no presence in Niger. Although contacts and working relationships were somewhat stronger in Burkina Faso, CAFOD had a limited working history in the Sahel region. An internal assessment of the situation in Niger was conducted at the end of June 2005, and resulted in the recommendation that CAFOD immediately contribute £76,000 ($150,000) to an existing appeal from CADEV (SOA 08/2005), the newly formed Caritas Niger and Bald conglomerate, for a Food Security Support Program10. The document made other recommendations, which included an assessment team visit Niger to explore appropriate opportunities for further intervention. During late June and early July 2005 international media coverage broadcast images and details of a horrific situation in the Sahel, focusing on severely malnourished children in targeted regions of Niger. CAFOD continued to track the situation with working groups and a formal Bubbling Emergency Group, which first met on July 15, 2005 11. On July 19th, 2005, the Humanitarian Department of CAFOD recommended use of £100,000 from the General Emergency Budget to fund Niger and Burkina Faso’s respective SOAs. Niger’s portion was formally approved on July 25; £66,000 ($130,000) to CADEV’s Food Security Support Program (SOA 08/2005), which included support for food for work, subsidized food sales, replenishing grain banks, seed distribution, and nutritional recuperation centers. Media attention to the situation in Niger prompted unprecedented public response. With no formal appeal, donor contributions to CAFOD would reach £250,000 ($500,000) by August 12th. Thus, by late July CAFOD was under external pressure to explore all possible strategies for intervention in Niger. A major factor contributing to the decision of how and when to intervene in Niger surrounded capacity. Not only did CAFOD lack history or presence in Niger, but human resources in the Humanitarian Department were already stretched to capacity due to extensive involvement in Tsunami and Darfur relief efforts. On July 22, CAFOD held a conference call with Trocaire, IRN, SCIAF and CRS 12. During this conversation, CRS and IRN, both of whom were presently in Niger, responded positively when asked about their ability to utilize a cash donation from CAFOD. A commitment of £100,000 was made to CRS on August 3, 2005 for their 2005 Emergency Response to Locust and Drought Induced Food Insecurity in Niger.

9 www.wfp.org, accessed May 17, 2005. 10 A. Dutton, An Overview of the Niger Nutritional Crisis, 26 June 2005 11 July 15, 2005 Niger and Burkina Faso Food Crisis BEG meeting minutes 12 July 22, 2005 conference call notes

11

The Disasters Emergency Committee (DEC) contacted CAFOD in July 2005 regarding their participation in a potential DEC Appeal. At that time, CAFOD needed time to further investigate potential implementing partners and their capacity to effectively utilize and manage funds received through a DEC appeal 13. Thus, based on limited staff capacity and limited means through which to respond in the Sahel, CAFOD decided not to take part in the DEC appeal, which was ultimately launched on August 3, 2005. CAFOD held a Niger/Sahel planning session in late August 2005, the outcomes of which included justification of a field assessment. Based on very limited staff capacity – all four humanitarian officers were on scheduled travel or leave – CAFOD recruited an independent consultant to conduct a 3-4 week field visit to Niger and Mali. The objectives of the visit were to consider the merits of numerous funding requests already received, to assess capacities of the various partners involved, and to guide future decision making regarding CAFOD’s involvement in the region 14. Findings from September/October 2006 field-visit reified CAFOD’s previously held belief that the food crisis itself was coming to an end and that it was too late to respond to immediate needs. Findings confirmed that CAFOD’s energy and resources would be better spent adapting interventions towards rehabilitation and longterm development in preparation for a healthier 2006 15. On the basis of findings from this report and a November 2005 Joint Evaluation conducted by CARE, Save the Children, World Vision, and CRS (Joint Evaluation), CAFOD agreed to fund the following grants:

• £63,398 to IRN’s Water and Sanitation Program for Niger

• £141,243 to CRS/HKI’s Nutrition programs in the Dosso and Zinder regions • £142,857 to CADEV’s Community Rehabilitation after Food Crisis

CAFOD staff conducted subsequent monitoring missions in January, May, and November 2006. Reports from these visits present detailed monitoring of use of funds, a review of the nutritional programs, and situational assessment regarding plans for future work in Niger. On the basis of these findings, further funding was awarded to IRN’s Nutrition and Health Improvement Project (£57,241), and CRS’s Extension of nutritional

rehabilitation activities in the district of Tanout (£151,968). In March 2007, CAFOD committed to project extensions for CADEV and CRS. CAFOD’s stated objective is to continue management operation to the nutritional programs and to facilitate hand-over to the GoN. Similar negotiations are ongoing with IRN. CAFOD intends to spend its remaining funds for Niger in supporting handover efforts of all three partners. CAFOD hopes to support each of its partners through the end of 2007; negotiations are currently underway.

13 Individual Agency Position: proforma for deciding whether to launch a DEC appeal 14 Monitoring Assignment to Niger - TOR 15 P. Mougin, Monitoring and Evaluation of CAFOD Supported Programmes in Niger

and Mali, October 2005.

12

4. FINDINGS

The Report findings are divided into two sections: (1) Program level findings for the three partnering agencies, based on DAC criteria, and (2) CAFOD organizational management response, based on: Niger as a strategic fit, partner and project selection, and programmatic support. Specific findings and recommendations for each partner are included in Appendix III.

4.1 IMPLEMENTING PARTNER RESPONSE

4.1.1 Relevance/Appropriateness

CAFOD’s decision to provide financial support for food aid activities, nutritional recuperation centers, and water/sanitation developments to its implementing partners, CRS, CADEV, and IRN, was in line with the needs and priorities of the country during the time of intervention. This determination was well researched and justified by findings of the September 2005 CAFOD site visit to Niger. Niger reached a food security crisis by May 2005 (see 3. Introduction). By August 2005, this situation had deteriorated to an emergency. At this time, CAFOD determined their most strategic approach in Niger was through partnerships with agencies already working in country16. Each of the three partnering agencies aims to alleviate the suffering of the most vulnerable populations. With niches in development ranging from food security (CRS) to nutrition related to blindness (HKI), to geographic expertise (CADEV), each of CAFOD’s partners was an appropriate partner for nutritional intervention. At the time, CRS was feeding an estimated 220,000 Nigeriens through food aid and looking to scale up programming by another $US 2 million. IRN had distributed 10 tons of food aid and set up 25 supplementary feeding centers and 5 therapeutic feeding centers in the south of the country. CADEV, the Nigerien Caritas partner, had been working closely with Caritas Germany and begun implementing programs that included food for work, subsidized food sales, replenishing grain banks, seed distribution, and nutritional recuperation centers. CAFOD was mindful of the most appropriate type of intervention, given its proposed timeframe of implementation. In June and July 2005, as funding was secured for Niger and Burkina Faso, the SOA objectives were to secure food (namely grains) for targeted households. In August 2005, when the soudure (hungry season) in Niger was coming to a close, CAFOD funded interventions were targeted towards rehabilitation and food security for 2006 17.

16 A. Dutton, An Overview of the Niger Nutritional Crisis, 26 June 2005 17 P. Mougin, Monitoring and Evaluation of CAFOD Supported Programmes in Niger

and Mali, October 2005.

13

By choosing to work with CRS, CADEV and IRN, CAFOD assisted in the post-emergency relief effort in seven of eight regions of the country. This included geographic areas identified as most vulnerable due to pocketed locust and drought throughout 2004 (Tahoua and Maradi regions)18. CADEV and CRS/HKI have history working in the regions where CAFOD supported their interventions. IRN initially came into Niger in response to the GoN appeal for aid to provide support in the Tahoua region. Once in country, IRN proposed to change their geographic region of focus to Tillaberi, based on an overwhelming presence of other NGOs in Tahoua and a lack of resources in Tillaberi. Thus, CAFOD’s interventions were geographically appropriate as determined by the organizational history of each partner. The projects of implementing partners appropriately targeted the most vulnerable, however this area may be improved through future efforts. All programs targeted children 6-59 months, which reflects appropriate targeting for nutritional programs during nutritional crises. Other highly vulnerable populations, including lactating and pregnant women and PLWHA, should be included as outlined in the National Nutritional Protocol. Only CADEV has effectively included these vulnerable adult populations in their interventions. Additionally, increased community level screening for all cases of malnutrition will ensure that the most vulnerable are appropriately identified and targeted for intervention. This will require a decentralization of current efforts by all partners.

Sphere standards were appropriately employed for targeting construction of water points through IRN efforts. Sphere nutritional standards were used for screening and categorization of children with malnutrition. CAFOD partner agencies are currently comparing nutritional outcome data (recovery, death and default rates) to Sphere standards. However, most partners are comparing collapsed rates of all cases instead of disaggregating moderate and severe cases for comparison against Sphere standards. This will artificially inflate data presented, as moderately malnourished children are more numerous and have better recovery outcomes. Data are not currently presented to CAFOD in a manner that allows disaggregation so to calculate these rates. Data have been requested from all partners in this form. Further improvement for all partners lies in the appropriate use of funds for designated activities and improved reporting and communication where reallocation of funds occurs. CAFOD has universally encountered situations where budgeted funds were not used for designated activities. In some cases, the reallocation of funds is not discussed with CAFOD until the end of the funding period. This “rollover” of funds has the capacity to greatly reduce the overall appropriateness, as well as effectiveness and efficiency of a program as originally planned. CAFOD should work with partners to improve project planning and then hold them accountable for all funded activities.

18 Early Warning System, Ministry of Agricultural Development, GoN

14

4.1.2 Connectedness

One of the strengths of the CAFOD programs is their focus on long term planning and impact, even during short-term emergency interventions. When CAFOD decided to intervene in Niger in 2005, a consultant was recruited to assess the situation in Niger, ensure the most effective CAFOD strategy for intervention, and take into account long term planning and impact of the projects. Nutrition remains a high priority among humanitarian agencies working in Niger. Key organizations include UNICEF, Concern, IRN, CARE International, International Red Cross, Save the Children, World Vision, CADEV, Médecins Sans Frontier, and Action Against Hunger. These organizations provide an array of development activities, including income generation, recuperation of land, support for off-season gardening, and reconstruction of wells/schools/cereal banks. Additionally, some operate supplemental and therapeutic feeding centers, generally intervening in areas of previous organizational intervention or as directed by UNICEF. Addressing malnutrition in Niger requires both short term emergency relief and long term development projects. With 40% of children under-five under weight for age standards and 40% of children under-five under height for age standards, Nigeriens entered what would become the food crisis of 2005 in a precarious situation 19. Thus, effective measures to address structural malnutrition and cyclical acute malnutrition are an essential component of all long term strategies in Niger. Connectedness between CAFOD implementing partners and other existing programs and structures has been good. Each implementing partner has a rich history of collaboration with a number of different partners. UNICEF has coordinated the overall nutritional response in Niger. They have held regular meetings, provided venues for sharing of information among organizations, set standards to ensure comparability of data, and have ensured appropriate targeting and service delivery methodologies. UNICEF and WFP have provided in kind contributions, including medical equipment, grains, and supplementary/therapeutic foods (PlumpyNut, CSB). CRS, IRN, and CADEV all have worked closely with UNICEF and WFP. CRS and HKI work hand in hand to operate feeding centers in Doutchi and Tanout districts. These programs are extremely well integrated into the national health system and are moving towards a strategic handover (foreseen December 2007). CRS also works closely with local and federal government, as well as other UN and aid organizations, so to ensure appropriate response. There is long standing history of collaboration between CRS and CADEV. IRN has worked closely with the Regional Health and Disease Control Department of Tillaberi, and the Health District Departments of Tera, Tillaberi, Filingué, and Ouallam. IRN has demonstrated good connectedness and flexibility by responding to needs where other NGOs or the GoN demonstrate need. For example, in Kofouno, Plan International

19 UNDP Human Development Report, 2005

15

was operating a feeding center prior to the 2005 crisis. During the crisis, Plan International asked IRN to assist in scaling up operations, as they were not able to respond on their own. IRN operated the feeding center until 2006 when Plan International once again took over operations. CADEV has twenty CSD (Committée de Solidarité et Développement) throughout the country, and it has effectively used and developed these committees to respond to local needs during the 2005 crisis and recovery period which followed. In addition to its own programs, CADEV has provided community level support and expertise to a number of other projects, including a food distribution project with Projet de Réhabilitation des Handicapés et aux Aveugles du Niger (PHRAN), a food distribution project with Plan Niger, and a food distribution project under a WFP appeal. Despite strong connectedness and history of collaboration by all partners, CAFOD should prioritize increased communication and collaboration among its partners. CADEV and CRS have a history of working together, though neither has any historical relation or solid understanding of Islamic Relief and their efforts in Niger. This is seen as an area for great improvement, especially considering the differences in organizational strengths and weaknesses among partners. Increased collaboration between CAFOD funded partners has the potential to greatly increase the impact of each organization. Two of the three implementing partners are currently in the process of integrating CAFOD funded projects into local and national health structures which intend to provide longterm support. CRS/HKI and IRN are working closely with health and other officials of GoN. Namely, the Health Worker (agent de santé) at each Health Center (centre de

santé integrée, CSI) is a state agent of the national health system and is paid by the GoN. CRS/HKI and IRN are providing ongoing support via training, community health workers, and structural support for the management of these centers. Despite extremely good connectedness to existing government structures, CRS/HKI and IRN both stand to improve their connectedness to the communities they serves. This is seen as a weakness for CRS/HKI particularly, as efforts to reach into the community were programmed for 2006 and did not occur. In contrast to the highly integrated nutritional programs of IRN and CRS/HKI, CADEV operates a number of its own nutritional programs. These centers run parallel to government structures, though are integrated into UNICEF and WFP’s collection of partners. And while a lack of integration into the national health system is seemingly problematic to sustainability, there are clear advantages to a parallel structure, especially if the concern voiced by health agents surrounding the GoN’s ability to maintain the centers is founded. Many of the centers were operational prior to the food crisis, and will likely continue to operate if CAFOD funding ceased; CADEV’s programs are exceptionally well connected to the community. All of the partnering agencies have demonstrated a concerted effort to inform and, where possible, work with civil service agents of the GoN. This is not always possible, as the GoN often requests large fees for their participation or accompaniment. CAFOD may

16

want to discuss an organizational strategy for incorporation of civil servants into projects (including budget line items) or for appropriately informing and otherwise dealing with GoN officials. CAFOD participates in a few regional efforts as well. CAFOD is a participating member of the Sahel Working Group, made up of representatives from numerous UK based NGOs working in the Sahel. This group is currently funding a study to look at the links between policy/strategy and program/action plans that affect the Sahel. This study aims to identify where gaps exist between policy/strategy and program implementation, focusing on Niger, Mali and Burkina Faso. CAFOD staff have also participated in meetings of Caritas partners working in the Sahel. This Caritas Sahel working group, called CERAO, aims to promote dialogue and collaboration between CERAO members and others in the Caritas Internationalis network; to develop regionally coordinated programs to respond and, where possible, prevent emergencies; to support short and longterm food security strategies; and to facilitate advocacy efforts and support exchange of information between northern and southern partners in West Africa. CAFOD has participated in early meetings of this newly established group.

4.1.3 Coherence

The coherence of CAFOD’s efforts in Niger is assessed by (1) how well CAFOD partner programs complement each other and align with wider efforts in country; (2) alignment of partner projects with CAFOD organizational policies; and (3) alignment of partner projects with national and international standards. Inter-Partner Alignment

CAFOD’s implementing partners’ programs have complemented each other. All three organizations have worked to operate feeding centers targeting moderately and severely malnourished children. These efforts have been made in conjunction with other projects which aim to address more longterm solutions to the nutrition problem in Niger. Programs including food for work, rehabilitation of soil, off-season gardening, provisions of agricultural inputs, and income generation have all been included in the myriad programs implemented through CAFOD funding. Education and inclusion of Nigeriens at every level of intervention has increased ownership and thus cohesion of the programs and local communities. In addition, issues surrounding public health have been included as well. Free medical treatment, new and rehabilitated water sources, vitamin A distribution, and routine vaccinations have contributed to the broad effort of CAFOD and its implementing partners to improve the lives, in both the immediate and the longterm, of people in Niger. Gender

Partner interventions are in alignment with CAFOD’s policies on gender. They have focused on nutritional programs that target children 6-59 months. All programs work with mothers at each level of intervention, from sensitization, to screening (mothers help during anthropometric measurement), to treatment. Under current procedures, mothers are also given accommodation if a child is admitted to a CRENI. Another way that

17

gender has been appropriately considered is through appropriate representation on all management committees. At least one woman is appointed to all IRN water/sanitation management committees. Additionally, in 2005 CRS noted that a number of their interventions were female dominated because of the unusually high portion of men who had migrated in search of work. The inclusion of pregnant and lactating women in nutritional interventions should be considered as a way to improve partner efforts’ alignment with CAFOD’s gender policy. Child protection

CAFOD partner efforts are in alignment with CAFOD’s child protection policy. During screenings for malnutrition and subsequent treatment, all partner procedures implicate a parent’s presence. Mothers are educated on health seeking behaviors so to avoid neglect and strive for appropriate provision of food. The overarching goal of the partners’ intervention – to reduce malnutrition among children – is an essential component of the CAFOD child protection policy. Despite good coherence, a review of CAFOD’s child protection policy with implementing partners, specifically regarding issues of child neglect, may be beneficial for partner programs. HIV/AIDS

HIV/AIDS has been identified by CAFOD as a priority sector, and the organization strives to mainstream HIVAIDS considerations in their work. There are clear venues for improving HIV integration into existing partners’ programs in Niger. Currently, CADEV is the only partner that routinely screens and treats adults for malnutrition; HIV/AIDS patients are not currently included in IRN or CRS/HKI nutritional programs. Environmental sustainability

CAFOD’s organizational interest in environmental sustainability is another area of potential improvement among partners in Niger. As a Sahelian country annually on the brink of survival and at the mercy of rainfall and subsequent crop success/failure, desertification and global climate change are of paramount importance to Niger. CAFOD should make explicitly clear to partners its interest in issues surrounding a sustainable environment. Already, partners are engaged in efforts such as off-season gardening, seed improvement, and soil rehabilitation. These efforts should be recognized if not further supported by CAFOD. International standards

Numerous international standards have been employed to ensure quality control during CAFOD partner interventions. Sphere standards for nutrition and water/sanitation have been consulted throughout the planning, implementation, and monitoring of each of the partner’s projects. IRN used Sphere guidelines to identify and prioritize water points and latrines at health facilities. As previously outlined, nutritional screening and categorization of malnourished children has followed Sphere guidelines, though outcomes, as presented by most partners, are not comparable to Sphere standards. Nutritional centers operating under CAFOD funding boast an average recovery rate of 92%, a 7% default rate, and 1% mortality rate. Despite need to disaggregate this data, all partnering agencies achieved outcomes will within the Sphere recovery and default

18

guidelines (SPHERE recovery and default guidelines are 75% and 15%, respectively, for both severe and moderately malnourished children). Sphere standards for mortality rates among children in feeding centers are different for moderately (less than 3%) and severely (less than 10%) malnourished children, thus aggregated data is not sufficient for reporting against Sphere standards of mortality. Reporting of nutritional data needs to be improved among partners so that CAFOD may appropriately assess Sphere standards by CRENAS, CRENAM and CRENI individually instead of collectively. All partner agencies in Niger have operated within the scope of the Red Cross Code of Conduct for NGOs. Specifically, as outlined in the Code of Conduct, these agencies have upheld the following principals:

1. The Humanitarian imperative comes first. 2. Aid is given regardless of the race, creed or nationality of the recipients and without adverse distinction of any kind. Aid priorities are calculated on the basis of need alone. 3. Aid will not be used to further a particular political or religious standpoint. 4. We shall endeavor not to act as instruments of government foreign policy. 5. We shall respect culture and custom. 6. We shall attempt to build disaster response on local capacities. 7. Ways shall be found to involve program beneficiaries in the management of relief aid. 8. Relief aid must strive to reduce future vulnerabilities to disaster as well as meeting basic needs. 9. We hold ourselves accountable to both those we seek to assist and those from whom we accept resources. 10. In our information, publicity and advertising activities, we shall recognize disaster victims as dignified human beings, not hopeless objects.

The evaluation found no violation of this Code of Conduct by partners. National standards

Beyond international standards, there are also national standards and protocols within which partners are expected to act. Of significance in this context is the National Nutritional Protocol (NNP) for Niger. The NNP was revised in 2006, and discussion herein is based upon the revised draft, dated December 2006. Despite good overall alignment with the NNP, a number of standards outlined in the NNP are not currently being met or upheld by CAFOD partners. For example, the NNP outlines that at-risk adults (including PLWHA, lactating and pregnant women, and tuberculosis patients) who meet outlined anthropometric measurements will be taken into care by the nutritional feeding programs. Currently CRS/HKI and IRN feeding centers are not screening or targeting any adults. Additionally, the NNP outlines that protective rations and exit rations are to be used only exceptionally, as in during the soudure, during an emergency situation, or in the case of non-respondent patients. These rations are being used regularly by CADEV, despite recommendations by CAFOD in January of 2006 that use of these rations be terminated. Additionally, the NNP excludes any additional ration post

19

documented recovery. Based on field visits and key informant interviews, this continues to be an issue within CADEV programs. Last, the NNP specifically outlines the need for follow up on children who abandon the program. This is an ongoing issue at all of the centers visited, and the major problem in adherence to protocol is lack of human resources. Despite the exceptions outlined above, partner adherence to the NNP is quite good. A majority of health workers have been through an official training on the NNP, and those who haven’t yet intend to do so under UNICEF’s next round of trainings. A major obstacle to coherence that persists in Niger is the discrepancy between the NNP Protocol and a CTC approach.20 Although the NNP claims to follow a CTC approach, there are clear differences – specifically the decentralization of screening and treatment of malnutrition and the enrollment of moderately malnourished with medical complications into CRENI. This discrepancy makes it difficult to hold partners accountable to either standard, as each contradicts the efforts of the other. It also makes data comparability between partners very difficult, as some partners (CRS/HKI) are following NNP and treating malnourished children with medical complications through outpatient CRENAM while others (CADEV and IRN) are following a truer CTC approach and referring these patients to the CRENI.

4.1.4 Coverage

Early discussion of CAFOD funding to the region included Niger, Burkina Faso, Mali, and Mauritania. Based on international data that were being presented in and around August 2005, as well as findings from the CAFOD field visit in September/October 2005, Niger was prioritized over other Sahelian countries for further intervention. Despite regional structural causes of malnutrition and yearly factors such as drought and locust infestations that affect the Sahel regionally, CAFOD was right to prioritize Niger during the 2005 crisis, as the situation there was driven by additional factors unique to Niger. Specifically, actions and inactions of the GoN and exacerbated food insecurity in Niger.21,22 CAFOD used the historical advantage of each of three organizations to geographically target response within Niger. Intervening in and around the Tillaberi, Maradi, and Zinder regions of the country was in accordance with need outlined in numerous reports, including those of Niger’s Early Warning System. CADEV works within four additional regions, thus their efforts were more widespread. Within each of these regions, children under-five were targeted for treatment of malnutrition. Children are among the most vulnerable during a food crisis. Targeting children under-five is in alignment with

20 Collins, Steve. Changing the way we address severe malnutrition during famine. The Lancet, 2001. 21 Mousseau, F. Sahel: A Prisoner of Starvation? Study of the 2005 food crisis in Niger.

October 2006. 22 CARE, CRS, World Vision, and Save the Children (UK), Joint Evaluation of the

Humanitarian Response to the 2005 Food Crisis, November 2005.

20

Sphere standards of intervention, both as a proxy for generalized malnutrition in the population, as well as treatment of the most affected. PLWHA should be included in malnutrition screening and treatment programs (see 4.1.3 Coherence). In order to achieve the highest level of coverage, this vulnerable population should be included in future efforts. One of the most difficult components of work in Niger is reaching the most vulnerable populations. A substantial portion of Nigeriens are pastoralists, living entirely off of the livestock they raise. These populations remain nomadic, following their livestock in search of pasture and water. Nomadic populations are among the most difficult to find, to reach, and to serve. Their isolation, however, also makes them among the most vulnerable. By relying entirely on livestock, these populations are at much greater risk when drought or locust invasion occurs. Because it takes on average 4-7 years to rebuild a heard of animals (lost to starvation, disease, or forced sale), pastoralist communities remain highly vulnerable for years after harvest may have returned to normal levels. In their final round of funding, CRS/HKI increased coverage in Tanout, an area that contains both agropastoralist and pastoralist communities. CADEV has explored creative solutions in Bermo, including teaming with CRS to create a mobile CRENAM/S that services nomadic populations at designated wells throughout the region four days a week. Efforts to target pastoral communities must continue and further efforts to include them in educational sessions and trainings on improved nutrition should be developed. As well, they need to be made aware of services, such as supplementary and therapeutic feeding centers, so that they are more likely to access one in time of need. It is difficult to estimate the coverage of vulnerable populations by CAFOD funded nutritional programs. Each partner’s project served a greater population (by number) than it intended to at its onset; though, inevitably, some populations were missed. As demonstrated internationally in Malawi and other African countries, a true CTC approach could substantially increase coverage of nutritional feeding programs.23 Community level screenings for malnutrition and the decentralized distribution of rations to a community or case de santé level would both improve coverage of the current nutritional programs. Proper assessment of coverage is a Sphere standard for nutritional programs. There are substantial human and financial resources required to complete a coverage assessment. This may be an area in which CAFOD’s technical expertise could serve not only its partners but also other actors working towards improved nutritional status in Niger.

4.1.5 Efficiency

CAFOD’s response to the food crisis of 2005 optimized finances and time by working through implementing partners with a presence in Niger. From July 2005 through March

23 V. Gatchell, The sustainability of Community-based Therapeutic Care (CTC) in non-

acute emergency contexts, 2005.

21

2007, CAFOD contributed £665,078 ($1.3 million) to three partnering agencies for intervention through nutritional programs. These agencies admitted 110,892 children to feeding centers throughout the country, 92% of whom recovered. Though targeted towards nutritional program, this funding also contributed to broader organizational efforts to secure access to food, including food for work (FFW), subsidized sale of grains, rehabilitation of cereal banks, and distribution of free food. Additionally, CAFOD contributed £63,398 towards IRN efforts to increase water and sanitation in the Tillaberi region. This funding supported three new boreholes equipped with hand/pedal pumps, the rehabilitation of 10 non-functional boreholes, 4 block latrines, and training of oversight committees. CAFOD partners have lauded the organization’s efficiency, especially in making funds available with very quick turn around. Where new funding has been proposed, communication between CAFOD and partners has relied heavily upon email. Exchanges have generally included two to three rounds of comments, questions and feedback. Communication between CAFOD and partners is good, though may be improved where an intermediary exists. Thus, for IRN, where communications between CAFOD and in-country IRN staff must go through Birmingham, there is a substantial reduction in efficiency of communication and sharing of information. This delay puts obvious strains on time efficiency, as delays in communication often translate into delays in action or availability of funds. Likewise, where CRS is an intermediary to HKI, efficiency in communication stands to improve. Communication of program impact – specifically nutritional data, which is a primary indicator each of the three partners efforts – should be streamlined. A standardized UNICEF form for monthly submission of nutritional program data is already in use by all three partners. CAFOD should request that the Humanitarian Officer be copied on this monthly submission of raw data when it is submitted to UNICEF (including admissions, recoveries, deaths, transfers, and abandons, reported by CRENAM, CRENAS, and CRENI). This will facilitate CAFOD’s ability to compare partner performance to Sphere guidelines and to aggregate data across partners more effectively. Another area for increased programmatic efficiency surrounds the occurrence and handling of unspent funds. Several times since initial funding, partners have budgeted and CAFOD has funded program activities that, for one reason or another, were not completed during the life of the grant. In several of these instances, only at the end of the contract when finances were being reviewed was the issued addressed. In some cases, a no-cost extension was made, in others the funds had already been spent on other activities. CAFOD should hold partners accountable for funds as allocated under contract, except where mutual written agreement (email acceptable) has determined that funds will be otherwise spent. This process ensures accountability to both donors as well as beneficiaries, without which overall program efficiency stands to be dramatically reduced.

22

4.1.6 Effectiveness

This section assesses the effectiveness of CAFOD’s overall response. Effectiveness measures the extent to which a set of activities achieves its purpose, and is best measured against program objectives and indicators set out at the beginning of an intervention (see Appendix IV, Partner Specific Feedback for assessments of the effectiveness of each implementing partner) A major weakness in CAFOD’s involvement in Niger is the lack of clearly defined objectives, from the beginning, for organizational involvement. In order to assess effectiveness, it is essential that clearly defined objectives be laid out. Assuming on the basis of selected partner objectives that CAFOD’s perceived its role as to increase access to food, reduce suffering from acute malnutrition, and increase food security for vulnerable populations, CAFOD was effective in their efforts. CAFOD funded programs have achieved the following outcomes since July 2005:

• 73 nutritional centers operating • 110,892 children admitted to nutritional centers

! 92.0% recovered (all children, severely or moderately malnourished) ! 0.6% died (all children, severely or moderately malnourished) ! 5.4% abandoned the program (all children, severely or moderately

malnourished) • 3 new and 11 repaired boreholes with hand/pedal pumps (IRN)

CADEV projects have achieved the following outcomes (excluding the nutritional component):

• 562,446 FFW beneficiaries • 353,210 Cereal Bank beneficiaries • 134,866 Subsidized sale beneficiaries • 123,132 Free distribution beneficiaries • 130 wells, 9 boreholes, and 3 water basins secured

In order to appropriately compare CAFOD funded projects to Sphere standards, partner reporting of nutritional data must be improved. Currently, partners report nutritional data in a variety of ways, which do not allow for breakdown of raw data by type of feeding center (CRENAS, CRENAM, CRENI). By requesting receipt of UNICEF’s standard monthly reporting form, CAFOD can ensure that they acquire the necessary data to hold partners accountable to Sphere nutritional standards. CAFOD partners, as outlined in Appendix III, have all achieved overall high levels of success in reaching their programmatic objectives. Data from the nutritional centers indicate some variation in effectiveness by partner, as indicated by recovery rates, abandonment rates, and mortality rates. Specifically, IRN had a lower recovery rate (89.5%) compared to either CRS/HKI or CADEV (94.6% and 93.2%, respectively). However, comparability across partner nutritional programs is limited by a number of confounding factors including population density, timeframe of program intervention,

23

target population livelihood (pastoral vs. agro-pastoral), and complementary program interventions. One element of partner programs that can be compared is the educational component, and it is clear that CADEV has been much more effective at prioritizing and utilizing its educational components to enhance the overall effectiveness and impact of its interventions. CADEV’s connectedness to the communities it serves contributes to its ability to effectively reach its IEC objectives. CRS/HKI and IRN both indicated intent to increase efforts at a community level during the most recent phase of CAFOD funding. The whole of the international aid community was slow and, ultimately, late in responding to the food crisis in 2005. Confusion surrounding data describing the pending crisis, price controls, and rumors of border closings for trade all contributed to a delayed response. Despite good efforts to monitor the situation in Niger and effective use of organizational mechanisms in place at the time, CAFOD’s decision if and how best to intervene took a substantial amount of time. Discussions regarding the best way to intervene date back to June 2005. The BEG group was assembled in July and the assessment visit was made in August 2005. As history has now shown, the delayed response by the GoN and the humanitarian community may have been a driving force in pushing Niger from a food crisis to an international emergency. CAFOD has since adopted Corporate Emergency Procedures, which will be utilized should a situation similar to Niger’s 2005 crisis emerge. The new procedures include an early warning system that will ideally provide the information needed for an appropriate and timely determination of corporate decision and direction, through the establishment of a Corporate Emergency Group (CEG). These procedures are intended to increase the efficiency with which CAFOD can respond to future emergency situations. CAFOD and partners worked closely with UNICEF and WFP in the operation of feeding centers throughout the country (see 4.1.2 Connectedness). CAFOD worked closely with partners and facilitated improved working relationships between partners and key agencies when necessary. These collaborative efforts, in addition to others with local government and NGOs, increased the overall effectiveness of CAFOD funded programs to serve the most vulnerable population during and following the food crisis. Interview with nuns at the Saga center indicated that UNICEF/WFP support had dramatically changed the outcomes they were seeing among children, especially use of feeding supplements. CAFOD can increase the effectiveness of its partnering agencies by better communicating its technical expertise and explicitly offering said technical support once the need is identified. CAFOD should also work with partners to share lessons learned, as partner strengths and weaknesses vary greatly. Increased communication between CAFOD partners has the potential to increase overall effectiveness of all programs. Increasing IEC efforts in nutritional programs has the potential to greatly increase the effectiveness of all other efforts. Thus far, efforts have largely been targeted to emergency interventions to the exclusion of community IEC exercises. However, for

24

longer-term impact, communities must be educated and empowered to inculcate change themselves. Additionally, close monitoring and evaluation of programs may also increase effectiveness. As previously mentioned, redistribution of funds, redefining of target populations, and removal of certain educational components from a program all dramatically change the potential impact, and thus effectiveness, of a program. Monitoring and evaluation should hold partners accountable for all planned and implemented activities, CAFOD funded otherwise.

4.1.7 Impact

Though impossible to tease out proportionate share, CAFOD undoubtedly contributed to the dramatic overall reduction in malnutrition in Niger from 15.3% in November 2005 and 10.3% in November 2006.24 CAFOD funded programs admitted 110,892 children under-five into nutritional programs, with a global recovery rate of 92.0%. UNICEF, a major coordinating body for nutritional efforts in Niger, estimated that 290,000 children were admitted to feeding centers in 2005 and an additional 382,400 in 2006.19 Based on these numbers, CAFOD funded interventions accounted for 16% of admissions during 2005-2006. CAFOD funded programs also contributed to FFW, soil rehabilitation, increased hygiene and sanitation, and preventative medical treatments, including Vitamin A distribution. These efforts clearly benefited beneficiaries of the respective programs. Though it is too early to measure the longterm impact, these projects were implemented with the hopes of effecting longterm change regarding food and livelihood security. Immediate impacts reported by beneficiaries include changes in child behavior and eating practices. Mothers of children enrolled in nutritional programs (CRENAM) shared stories of increased appetite, energy level, and noticeable growth and development among children enrolled. Beneficiaries bemoaned the termination of the protective ration, as they observed great improvements at household levels under the protective ration. Though not all, a substantial number of mothers indicated that the nutritional program had given them the tools to prevent malnutrition from occurring within their family again. They referenced local foods and preparation practices that enhance nutritional value and diminish exposure to infectious agents. Partner development of water and sanitation projects has also contributed positively to beneficiary communities. Health agents at centers where new boreholes have been drilled or old ones rehabilitated report the significance of having easily accessible clean water during childbirth. Community members who benefited from a new or rehabilitated water source report using water more liberally and recycling less. Health agents report that children in beneficiary communities have noticeably better hygiene than before. One

24 Malnutrition challenges child survival in Niger, despite recent gains, UNICEF Newsline, www.unicef.org, accessed May 15, 2007.

25

community, Famale, explained how certain wells were now used for drinking water, where others were designated for non-consumption use. Beyond the physical structures developed through CAFOD funding, community management committees have been established and the populations educated on appropriate use and management. These committees have been trained and are in place to ensure longterm sustainability of wells and latrines, which will reinforce the project’s impact over time. Overall, communities that benefited from increased water points and/or latrines have experienced increased hygiene and sanitation levels.

26

4.2 CAFOD ORGANIZATIONAL RESPONSE

4.2.1 Strategic Fit

‘By 2010 CAFOD will be a more effective and focussed agency, working to end poverty and injustice, reduce human suffering and loss of life and achieve global solidarity. We will be confident in our Catholic identity and active in global Catholic networks, while holding deeply to a partnership ethic.’25 In its Vision, “CAFOD is committed to building a world free from poverty and injustice where: all have access to food, clean water, shelter and security; to a livelihood, health and education; all can participate in shaping their societies and their world”. CAFOD’s mission is “to promote human development and social justice in witness to Christian faith and Gospel values. . . work[ing] alongside people in need to reduce poverty and bring about sustainable change through development and humanitarian programmes… by empowering people in need regardless of their race, gender, religion or politics to bring about change through development and relief programmes overseas.”26 CAFOD’s Humanitarian Mandate states: “In solidarity with those hurt and impoverished by disasters, and in order to build upon their hope and maintain their human dignity, CAFOD has always responded to emergencies with compassion. Our longterm capacity and commitment to responding in emergencies is a fundamental and essential part of delivering our humanitarian mandate.”27 The quotations above, taken from CAFOD organizational documentation, demonstrate that an organizational response to the food crisis in Niger was appropriate and had good strategic fit with CAFOD’s organizational strategic vision. In July 2005, a BEG was developed for Niger. The criteria under which BEG are created include: the onset of a natural disaster likely to need major response; longterm or complex emergencies suddenly reaching a critical stage; substantial media coverage of an emergency; the possibility of a DEC appeal; urgent requests for assistance from CAFOD partners; the need to develop or clarify a CAFOD position on a particular emergency; indications from CAFOD supporters suggesting that CAFOD should be responding to a particular situation; and the need to review progress on a particular emergency or respond to new factors.28 With the exception of the last criteria, the situation in Niger during May and June of 2005 perfectly matched the hypothetical Terms of Reference for a BEG. The development of a BEG group to determine how best to respond was also in alignment with organizational procedures in place at the time. Niger suffered both drought and locust infestation in addition to longterm chronic food shortages and 25 CAFOD 2010 Strategic framework 26 CAFOD’s Vision, Mission and Values 27 CAFOD’s Humanitarian Mandate (V3, 09.05.06) 28 Terms of Reference for Bubbling Emergencies Group

27

malnutrition. Media coverage in June of 2005 reported starving children in Maradi and Tahoua regions, and criticized humanitarian response up to that point. A DEC appeal was being discussed (and was ultimately launched in early August), and private donations began to pour into CAFOD, earmarked for intervention in Niger. When CAFOD spoke with potential partners, they indicated urgent need for increased funding. That CAFOD did not have any historical presence in or relationship with Niger contributed to the need for a BEG to determine the best way forward. Further evidence of the appropriateness of a Niger intervention is demonstrated through brief assessment of the criteria used to identify CAFOD 2010 priority countries.29 Though Niger remains a country of “strategic interest”, these criteria demonstrate the nature of Niger’s fit into CAFOD’s portfolio. 1. How does the country rank in the poverty indices? Niger ranked last (177/177) in the Human Development indices in 2005.30 2. What is CAFOD’s current and historical relationship with the country? CAFOD’s relationship with Niger stems from the 2005 food crisis. CAFOD is currently funding three partner agencies to improve nutrition, water/sanitation, and food security in the country. CAFOD financial support for Niger since the crisis has been at £ 728,476. 3. Is the Catholic Church an entry point for CAFOD? Yes, through CADEV. 4. Can we reach the poor and those suffering from injustice? Do we know how to do

this? Through partnerships with CADEV, CRS/HKI, and IRN, CAFOD has established relationships and has access to the most vulnerable and disadvantaged groups (malnourished children, pregnant and lactating women, and otherwise most vulnerable in food insecure communities). CADEV in particular offers a direct door into the communities its serves, built on a strong basis of solidarity, trust, and commitment. 5. What are the quality, depth and energy of our partner base? Relationships with CADEV, CRS/HKI and IRN have been developed through support for emergency responses in since 2005 and the related monitoring exercises. CAFOD continues to support each of these three partners in a current “exit strategy” phase. CADEV has recently restructured and they have the potential to design and implement far-reaching humanitarian and development programs. Their greatest strength is a solid connectedness to the communities with which they work. CRS and IRN appear to operate with high professional standards. CRS has had and will likely continue to have a longterm presence in Niger via USAID support for their ‘Food Security Initiative for Niger’. 7. What resources are available to support this program? Funding appears to be the greatest constraint to ongoing work in Niger. Thus far, Sahel Emergency funds have

29 Original analysis completed by Philippe Mougin, May 2006, See Niger Trip Report

May 2006 30 UNDP Human Development Report, 2005

28

supported all efforts in Niger. Future efforts should consider private as well as institutional funds. CAFOD began speaking with potential partners in July 2005. As previously outlined, staff in the Humanitarian Department were extremely overwhelmed at the time due to extensive efforts already underway in Darfur and Tsunami affected South East Asia. CAFOD agreed upon funding for CADEV’s Food Security Support Program (£72,222) and CRS’s Emergency Response to Locus and Drought Induced Food Insecurity in Niger (£100,000).

4.2.2 Partner/Project Selection

CAFOD’s decision work with implementing partners rather than enter the country and run a bilateral program was a good decision. The Humanitarian Section was already struggling to cover staff needs for its Tsunami and Darfur relief efforts, thus lacked the capacity to develop and implement effective programs. Additionally, the organization lacked any history with Niger, thus lacked the contacts and geographic expertise necessary to launch an operational efforts of its own. Though this would have been possible, an operational project for CAFOD in Niger would have been much less efficient financially and less effective in terms of time of the intervention. In August 2005, CAFOD funded a consultant to visit Niger and Mali to determine how best to utilize CAFOD private funds that had come in response to the Sahelian crisis. During the site visit, the consultant assessed efforts of CRS and CADEV, both of whom received CAFOD funding a few months prior. Information from this site visit, including information on other NGOs intervening at the time, contributed to CAFOD’s decision to fund ongoing rehabilitation and recovery efforts via CRS/HKI, CADEV, and IRN. A brief organizational description of each selected partner is presented below. CRS, a non-governmental organization founded in 1943 by the Catholic Bishops of the United States, is a Caritas member agency whose mission is to assist the poor and disadvantaged. Catholic Relief Service’s goal is to help all people reach their full potential in order that they may live in equality and peace. CRS has had a presence in Niger since 1996. CRS/Niger focuses on improving household food security as it works closely with a variety of partners to implement agriculture, health, education, microfinance and emergency response activities. Committed to the mission to serve the most vulnerable, CRS/Niger focuses its interventions on women, children, nomads and other high-risk groups.31 HKI, a non-governmental organization founded in 1915, is among the oldest international non-profit organizations devoted to fighting and treating preventable blindness and malnutrition. HKI has worked in Niger since 1987, where its principal expertise is nutrition (micronutrient supplementation, dietary diversification and supplementation, exclusive breast feeding and complementary feeding, nutritional monitoring, and nutrition and infectious disease). HKI is a technical assistance agency

31 www.crs.org, accessed April 18, 2007

29

that does not provide direct services; HKI builds local capacity by establishing sustainable programs, and provides scientific and technical assistance and data to governments and international, regional, national and local organizations around the world.32 Caritas Development Niger (CADEV) is a member of Caritas Internationalis. CADEV was formed in 2005 when the Bureau d’Animation et de Liaison pour le Développement (BALD) and Caritas Niger merged. Caritas Niger had worked in Niger for over 40 years and, through CADEV, continues to provide development and emergency assistance to vulnerable populations as well as occupying an advocacy role at the local level. Islamic Relief is a non-governmental organization which aims to alleviate the suffering of the world’s poorest people. It was founded in 1984 in response to the devastating famines in Africa that forced thousands of people to flee their homes and seek refuge in camps in several countries, including Niger. Since then, Islamic Relief has worked in over 20 countries responding to disasters and emergencies, as well as promoting sustainable economic and social development by working with local communities - regardless of race, religion or gender. The four main sectors of Islamic Relief’s work are emergency relief, development, orphans, and waqf. Upon completion of the emergency assistance intervention to address the malnutrition in 2005, IR established a full-fledged presence in Niger by finalizing its registration as a country program. IR Niger programs cover emergency response, post-drought rehabilitation, recovery, and development in the sectors of health/nutrition, education, WatSan and livelihoods.33 CAFOD’s selection of partners for rehabilitation and recovery efforts in Niger after the 2005 crisis was effective. CAFOD was able to utilize the Catholic church as an entry point by partnering with the newly established CADEV. Beyond typical advantages leveraged by using the church as a point of entry, working with the local Caritas agency was doubly important in Niger, where restructuring had just taken place. Additionally, by partnering with CRS, CAFOD continued to work through the church, with the added advantage of 10 years prior experience in the country and ongoing partnerships to increase household food security. Last, CAFOD’s decision to work with IRN allowed the organization to include water and sanitation efforts which were in line with WHO proposed efforts (increasing primary health care capacities) and to expand nutritional efforts further into the Tillaberi region. Partner selection and project selection were not independent; partners were considered based in part on their projects during July/August of 2005. CAFOD sought to build capacity of existing programs and to help fund those in the planning process. CAFOD’s decision to fund nutritional programs that aimed to distribute food and reduce the suffering and occurrence of malnutrition was appropriate during the emergency phase of the food crisis. As the situation moved from emergency to post-emergency, nutritional rehabilitation through integration of nutritional programs at a community level became

32 www.hki.org, accessed April 18, 2007 33 www.islamic-relief.com, accessed April 18, 2007

30

the focus of a majority of CAFOD funding. Simultaneously, CAFOD funded a water and sanitation project to increase access to safe water and latrines at health centers throughout the Tillaberi region. This was an appropriate time for a watsan intervention (January – December 2006), and remains an essential element in for ongoing development. Future efforts, appropriately, are aimed at improved water and sanitation, public health, and nutritional screening and treatment. Decentralizing nutritional programs and developing ownership and capacity at a grassroots level is paramount to prevention of future food crises. For future efforts, it is recommended that CAFOD reinforce partner capacity for efforts that directly address sustainability of the environment (see 4.1.3 Coherence). Niger exists in a precarious balance of nature, where chronic food shortages are at the mercy of evermore-unpredictable rain patterns and pest infestation. Arable land in Niger is scarce, and desertification and climate change threaten to worsen that reality. Simple planting efforts have shown progress in reversal of desertification in some areas of Niger. All of these factors make investment into agriculture and improved environmental conditions a priority for all those working in Niger. That CAFOD has an organizational mandate to prioritize environmental efforts makes it a natural funding fit among partners. There are a number of NGOs working in Niger whose focus is the environment. These organizations, including the Eden Project and International Fund for Agriculture and Development (IFAD), could be considered for future partnerships.

4.2.3 Program Support

CAFOD provided financial as well as technical support to its partners in Niger. Technical support was provided through monitoring visits conducted during September 2005, January 2006, May 2006, and November 2006. CAFOD received high marks from each of its partners concerning the technical support offered during each of these monitoring visits. CADEV reported that CAFOD facilitated improved relationships with key partners while on a site visit, as well as providing operational recommendations for improved management systems. CRS/HKI reported substantial gain from shared experience of the humanitarian officer and nutritionist conducting CAFOD’s monitoring visits. All partners perceive CAFOD as an exceptional funding partner. They laud CAFOD’s responsiveness, flexibility, and attention to detail. Partners also are genuinely impressed with CAFOD’s technical knowledge and understanding. Unfortunately, it is clear that CAFOD’s partners are not aware that sharing technical expertise is one of CAFOD’s organizational objectives; instead it appears that they see this “added value” as their good fortune and seem pleased to receive it. CAFOD can improve the quality of its partner programs by making explicit its organizational capacities for technical support, as well as its organizational objective to provide such support. Known channels for requesting technical support from CAFOD should be established, and CAFOD should include opportunities for sharing this technical support in each monitoring visit.

31

CAFOD’s monitoring visits appear to have concentrated broadly on the use of current CAFOD funding and potential for future action (considering both current context and potential of partners). Despite inherent value in each of these considerations, increased technical monitoring of partner activities, particularly nutritional programs, would improve accountability and effectiveness assessment of partners. Of great concern is the methodology surrounding collection and reporting of nutritional data. As previously outlined, standardized reporting of all admissions, recoveries, deaths, and defaults by CRENAS, CRENAM, and CRENI is recommended for all future CAFOD efforts. Additionally, program monitoring should include information on broad partner efforts and what portion (both financially and programmatically) is funded through CAFOD contributions. There are clear discrepancies in what CAFOD indicates it has funded (through GAP summaries) and what partners perceive CAFOD to have funded (narrative reports from CADEV and CRS). These data (indicated beneficiaries, total financial support, CAFOD financial support, and activity costs, e.g. total cost of operating a nutritional center) are essential for true assessment of impact, effectiveness, and efficiency. To illustrate this complexity, around 18 funding partners responded to the CADEV SOA for 2006. CAFOD funded around £143,000 of £1,396,685 in total funding. During early discussions, CADEV understood that CAFOD wanted to fund the nutritional component of the SOA, and all CAFOD funds went towards the nutritional rehabilitation program. CAFOD, however, only wanted to make sure the nutritional program was funded, but believed they were funding the general SOA. This discrepancy becomes germane when trying to assess effectiveness of the program from CAFOD’s perspective. Additionally, it is essential to know the overall cost of the nutritional program; were other financial contributions added to CAFOD funding? If so, how much? These questions are critical in generating financial efficiency numbers, which rely heavily upon total cost of programs. These numbers should be established and clarified through early monitoring, if not at the outset of funding. The number of monitoring visits that CAFOD has conducted since inception of programs in Niger in 2005 (4 excluding this evaluation) illustrates the organization’s commitment to understanding the context of the problem in Niger and ensuring a quality response from its partners. However there is substantial room for improvement in the way that CAFOD has supported its partner programs. Some of the clear ways in which CAFOD can improve its program support include: facilitation of coordination between existing partners; increased capacity building of partners, where needed and wanted; increase partner understanding of CAFOD’s strategic issues (gender, HIV/AIDS, technical support); and improved follow up. Most of the aforementioned items were at least briefly identified during previous monitoring visits, however the ways in which recommendations for change were presented to partners and the ways in which CAFOD followed up on these issues are not clear. For example, increased collaboration between CADEV and IRN in the Tera district was identified in the May 2006 report as an area of potential improvement. During the site visit to this region during the evaluation, it was clear that IRN and CADEV were still very unaware of the other’s efforts in the district.

32

5. CONCLUSIONS

5.1 Implementing Partner Response

Overall assessment of partner performance, based on DAC criteria, is good. CAFOD funded partners admitted 110,000 children 6-59 months into nutritional centers and ensured an average overall recovery rate of 92%. Water and sanitation has been prioritized and funded, and communities have been sensitized on pertinent issues. These contributions have reduced suffering and malnutrition brought on by the 2005 crisis and are stepping stones toward long term development for improved health and nutritional status in Niger.

5.2 CAFOD Organizational Response

The decision in June 2005 to fund implementing partners rather than initiate an operational response was an appropriate decision. In doing so, CAFOD increased the effectiveness (timeliness), efficiency (financial, logistical), and the overall impact of their intervention. Though the organizational process through which CAFOD reached the decision to intervene has since evolved, this evaluation indicates that the new CEG process would have come to the same conclusion, to intervene, as the BEG did. CAFOD’s monitoring visit in September 2005 provided evidence for further humanitarian need. It also provided key information about potential partnering agencies, which was required to make sound decisions concerning allocation of additional resources. Findings from this report drove CAFOD to prioritize resources in Niger and to, ultimately, fund programs through CRS, CADEV and IRN. CAFOD’s support to partners has been good, though targeted areas may be improved. Specifically, closer technical monitoring of nutritional data, improved partner reporting (broader project information included), facilitation of inter-partner collaboration, and explicit prioritization of CAFOD strategic areas (HIV/AIDS, gender, environmental sustainability, and capacity building) are all areas for improvement. CAFOD should distinguish the type of technical support needed by each partners. Conducting a monitoring visit with a technical support/capacity building component will be difficult to conduct across partnering agencies because of the distinct differences in strength, weakness, and organizational culture of each partner. It is clear that a tailored approach would require more time and, thus, more human resources. Additionally, the increased support outlined above would require an increased allocation of time at CAFOD’s London office to the programs in Niger. If CAFOD chooses to continue working with multiple partners in Niger, it is worth considering having one staff person decentralized to Niger. A decentralized staff person in Niamey could oversee partner relations, conduct ongoing monitoring, work with partner agencies for increased capacity building, increase awareness of CAFOD’s organizational objectives, and increase communication and efficiency between CAFOD and its partners. This staff person could also begin to

33

develop mechanisms for effectively sharing lessons learned among partnering agencies. In addition, this staff person could serve as an advocate for and intermediary between partner agencies and GoN. Having a CAFOD staff person based in Niamey may be an efficient and effective solution to the increased technical supervision and support recommended herein. It would also allow CAFOD a better understanding of the situation, as it evolves, in Niger. However, if CAFOD chooses to reduce the number of partners, management from London may be more feasible. The investment of the past two years in Niger and the success of both the projects and the relationships with partners justify ongoing CAFOD funding of programs in Niger. The situation of Niger, though extreme, is not completely unique. Mali and Burkina Faso, border countries to the west of Niger, also suffer from extremely poor demographic figures and rank at the bottom of UNDP’s Human Develop Index as well (175 and 174 respectively). Based on demographic data and geographic location, they are most likely to experience anything close to Niger’s 2005 food crisis in the coming years. Thus, it is worth considering the benefit a regional response against that of a Niger specific response. By engaging those countries now, through a Sahel operation, CAFOD would reduce the chances of another crisis and better position themselves to respond should the situation arise. CAFOD is currently participating in two Sahel working groups; one of UK based NGOs and one of fellow Caritas Internationalis partners. Ongoing discussion and identification of gaps between policy/strategy and program implementation, may justify expansion of programming to a regional instead of country level. This discussion is germane to CAFOD’s decision of where, strategically, to position future Niger efforts within the organization. The CAFOD response in Niger to date has been coordinated and managed through the Humanitarian Department. CAFOD’s future work in Niger and the Region could be located within the West Africa/Great Lakes (WAGL) Regional Desk Office should the strategic decision be made to cover the Sahel region.

34

6. RECOMMENDATIONS

6.1 Implementing Partner Response

6.1.1. CAFOD should ensure all vulnerable populations, including lactating and pregnant women and PLWHA, are included in nutritional programs, as outlined in the NNP. Increased community level screening for all cases of malnutrition will ensure the most vulnerable are appropriately identified and targeted for intervention (see 4.1.1 Relevance/Appropriateness).

6.1.2. CAFOD should facilitate increased communication and collaboration among

partners. Increased collaboration between CAFOD funded partners has the potential to greatly increase the impact of each organization (see 4.1.2 Connectedness and 4.1.6 Effectiveness).

6.1.3. Partner interventions are in alignment with CAFOD organizational policies on

gender and child protection. A review of CAFOD’s child protection policy with implementing partners, specifically regarding issues of child neglect, would be beneficial (see 4.1.3 Coherence).

6.1.4. CAFOD should ensure its organizational policy on environmental

sustainability is understood and adopted by implementing partners. Partners are engaged in efforts such as off-season gardening, seed improvement, and soil rehabilitation. These efforts should be further supported by CAFOD (see 4.1.3 Coherence).

6.1.5. CAFOD should support implementing partners in adherence to the National

Nutritional Protocol (NNP) (see 4.1.3 Coherence).

6.1.6. CAFOD should advocate rectifying discrepancies between the NNP Protocol and a true CTC approach (see 4.1.3 Coherence).

6.1.7. CAFOD should conduct a formal assessment to determine nutritional program

coverage. CAFOD could work within CSDs to conduct a coverage study of CADEV interventions, thereby building the capacity of CSDs to replicate coverage studies elsewhere (see 4.1.4 Coverage).

6.1.8. The CAFOD Humanitarian Officer should receive monthly nutritional data

sent to UNICEF (including admissions, recoveries, deaths, transfers, and abandons, reported by CRENAM, CRENAS, and CRENI). This will facilitate CAFOD’s ability to evaluate partner performance against Sphere guidelines and to aggregate data across partners more effectively (see 4.1.5 Efficiency).

6.1.9. CAFOD should hold partners accountable for funds allocated under contract,

except where mutual written agreement (email acceptable) has determined that

35

funds will be spent otherwise. This process ensures accountability to both donors and beneficiaries (see 4.1.5 Efficiency).

6.1.10. CAFOD should continue to support IRN and CRS/HKI and CADEV toward

integration with Government health facilities. Longer-term support is recommended to CADEV, with a focus on increasing CSD capacity in their respective catchment areas (see 4.1.2 Connectedness).

6.2 CAFOD Organizational Response

6.2.1. CAFOD should designate Niger a priority country. Niger meets or exceeds all designated criteria, with the exception of a known funding mechanism. CAFOD should explore possible private and/or institutional funding sources to enable ongoing efforts in Niger (see 4.2.1 Strategic Fit).

6.2.2. CAFOD should continue funding through 2007, incorporating partner-specific

evaluation feedback (see Appendix III, 4.2.1 Strategic Fit, and 4.2.3 Program Support).

6.2.3. Future CAFOD funded programming in Niger should be targeted towards

improved water and sanitation, public health, and nutritional screening and treatment. Decentralizing nutritional programs and developing ownership and capacity at a grassroots level is paramount to prevention of future food crises (see 4.2.2 Partner/Project Selection).

6.2.4. CAFOD should identify and provide technical support to each implementing

partner. If CAFOD continues to work in Niger with multiple partners, one staff person could be based in Niger (see 5.2 CAFOD Organizational Response).

6.2.5. CAFOD should ensure all partners have a clear understanding of its

organizational mission, vision, and strategic interests. 6.2.6. CAFOD should articulate clearly its project goals, objectives and exit strategy

to partners and/or beneficiaries before the implementation of programs (see 4.2.3 Program Support).

6.2.7. CAFOD should remain engaged in the international discourse on how best to

address malnutrition as a chronic emergency (see 4.2.1 Strategic Fit). 6.2.8. CAFOD should review the benefits a regional response in the Sahel versus a

Niger specific response. By engaging vulnerable neighboring countries now, through a Sahel-wide operation, CAFOD would reduce the chances of another crisis and better position themselves to respond should the situation arise (see 5.2 CAFOD Organizational Response).

36

Appendix I: Terms Of Reference

February 2007

Updated April 3, 2007 following initial briefing

Terms of Reference for the Evaluation of

CAFOD’s Response to the Niger Food Crisis

1. Background

Summary of crisis In 2004 Niger and other countries in the Sahel crops and pastures were destroyed by a large locust invasion followed by localized droughts. The late onset of rains in some areas affected the production of early maturing crops, worsening the seasonal hunger gap in 2005. Fears of food shortages led to speculative buying, which caused artificial shortfalls and rising food prices. As a result many households were forced to forage for wild food, sell their assets, migrate to neighbouring countries and incur debts to purchase food. Due to the scarcity of pasture many livestock died and pastoral households were forced to sell their livestock to buy food, which led to the deflation of livestock prices, thereby increasing the cost of food for pastoral families. These factors culminated in acute food shortages as grain prices rose beyond the reach of most impoverished rural households. Although early warning systems were in place following previous droughts across the Sahel, they did not forewarn of the extent of the food crisis and excluded analysis of the underlying problems of extreme poverty, chronically low nutrition status and reliance on highly vulnerable livelihoods. Whilst growing concern for southern Niger was expressed from 2004, the Government of Niger and agencies in the field did not highlight the urgency of the crisis or appeal for adequate assistance, which resulted in a poor response to the UN Flash appeal launched in May 2005. The government of Niger’s initial response was to sell subsided grain to the local markets most in need to avoid destabilising the market. However many households were too poor to afford even the subsidised prices. A major food crisis affecting nearly 4 million people followed. Although the situation has stabilised the crisis has weakened household’s ability to cope with future food shortages as they have incurred debts and their livestock, land and assets are depleted. In Niger malnutrition and related mortality rises annually in the months before the harvest when food is most scarce and diseases (such as malaria and diarrhoea) are exacerbated by the rainy season. Niger is the poorest country in the world, with 60% of the population living below the poverty line. The people of Niger therefore remain highly vulnerable to the interrelated factors of shortages in food production and rising food prices which led to the food crisis in 2005. CAFOD’s response

37

Prior to June 2005 CAFOD did not work in Niger or the other countries affected by the Sahel food crisis (with the exception of Burkina Faso where CAFOD has been supporting agro-ecology and literacy projects). However, in response to the urgent humanitarian needs and the concerns of our supporters, CAFOD made the decision to provide assistance to the people affected and launched an appeal to raise funds and awareness of the crisis. In July 2005 CAFOD responded to the Sahel food crisis through support to several Caritas implementing partners in Niger, Mali and Burkina Faso to implement emergency responses focused on food distribution and the treatment of acute malnutrition through supplementary and therapeutic feeding. In early 2006 once the urgent food crisis had stabilised CAFOD prioritised support to existing partners for nutrition rehabilitation and food security, aimed at preventing and treating malnutrition in the hungry months before the harvest. CAFOD also established a new partnership with Islamic Relief, supporting programmes to improve (i) water and sanitation infrastructure in health structures and (ii) nutrition rehabilitation and education. CAFOD is currently considering providing support to partners (Caritas Niger and CRS) for the handover of nutrition centres set up during the emergency to Niger’s Ministry of Health.

2. Purpose of the evaluation The evaluation will examine CAFOD’s overall response to the Niger food crisis in order to:

• Enhance accountability to stakeholders • Capture lessons to help improve CAFOD’s decision making for response to

emergencies • Capture organizational learning regarding CAFOD involvement in time-bound

interventions to be used in decision-making about CAFOD’s future in Niger and future interventions elsewhere.

3. Focus of the evaluation Although the evaluation will focus on CAFOD’s response management processes, in order to do so effectively it will be necessary to explore CAFOD partners’ performance and the significant successes and limitations of the programmes which make up this response. 4. Objectives of the evaluation The evaluation report should articulate findings, draw conclusions and make recommendations The evaluation will examine CAFOD’s management of the response to the food crisis in relation to:

• CAFOD’s priorities, competence and capacity at the time • CAFOD’s rationale to prioritise support to particular projects and partners • CAFOD’s level of monitoring, assessment of partners performance and strategies,

follow up and support provided by CAFOD for the response

38

The evaluation will assess CAFOD’s partners’ response and may consider the following questions, based on OECD/ DAC Criteria: Relevance/appropriateness: relevance assess whether the response is in line with local needs and priorities (as well as donor policy). Appropriateness is more focused on the activities and inputs and on whether humanitarian activities are tailored to local needs.

• How effective were CAFOD and our partners in assessing and analysing the needs and context?

• How relevant was the response to addressing the needs and priorities of the local communities and country? (E.g. was the distribution of food aid and establishment of nutrition centres relevant in the chronic food crisis?)

• Was the response relevant to addressing the needs of all beneficiary groups/ stakeholders?

• Did the response take the local wider issues and context into account (e.g. food markets, survival strategies, culture)?

• Were the resources and support provided appropriate to the local needs and context?

• How effectively have CAFOD’s own and general humanitarian themes been analysed and integrated throughout the response? (HIV/AIDS, gender, livelihoods, environment, protection).

• Was the overall response in line with our partner’s priorities, competence and capacity?

• How could relevance and appropriateness be improved? Connectedness: assess whether short-term emergency activities are carried out in a context that takes longer-term and interconnected problems into account.

• What impact has this response had on partners and their existing programmes? • How has this response built upon, supported and developed existing programmes

or structures (partner, government, UN and other players, representing north and south)?

• How do these programmes link with partners’ work in other sectors? • Have the programme approaches adopted supported an effective transition into

longer-term programmes (e.g. integration into national structures, ongoing maintenance and management through community based committees)?

• How has the response supported or disrupted communities’ ability to support themselves?

• How are partners placed to address Niger’s longer term food security issues or reduce the impact of future food shortages?

• How does this response fit with CAFOD’s plans for longer-term support to Niger? • How could connectedness be improved?

39

Coherence: assess whether there is consistency with relevant policies (such as security, trade and military), and in particular whether humanitarian and human rights considerations are taken into account in all policies.

• Have the different aspects (and programmes within) CAFOD’s response complemented or contradicted each other?

• How does this response complement or contradict CAFOD’s policies (gender, child protection, HIV/AIDS)?

• How is this response supported by wider efforts to address the systemic structures that make Niger vulnerable to food crisis? (E.g. debt relief, trade restrictions/ market regulations, raise the voice of the poor, donor fatigue/ slow response to the crisis, desertification and right to freedom from hunger).

• How could coherence be improved? Coverage: assess whether the major population groups facing life threatening suffering are reached, providing them with assistance and protection proportionate to their need and devoid of extraneous political agendas

• Were the resources allocated by CAFOD to Niger adequate in comparison with other emergencies? (in particular in the context of the regional food crisis)

• Did CAFOD and our partners identify and target assistance to the geographical areas and population groups on the basis of need? Were there any geographical areas or population groups identified as in need who did not receive assistance, if so what were the reasons for this? (E.g. areas covered by other NGOs, sharing of food, access etc.)

• What proportion of those in need did the response reach? • Who was supported by the various response activities, include breakdown of

beneficiaries (by age, gender, socio-economic group, ethnicity) by programme activity.

• How successful was the response in reaching the most vulnerable? • Have the programmes reached areas not covered by other agencies? • How could coverage be improved?

Efficiency: measures the qualitative and quantitative outputs achieved in relation to the inputs and compares alternative approaches to see whether the most efficient approaches were used.

• How efficient was CAFOD’s allocation of resources for the Niger response (in relation to the outputs)? In comparison with alternative approaches? (E.g. Operational response, greater support to particular programmes).

• What factors affected the efficiency of CAFOD’s overall response? (E.g. political context, logistics, working with local partners, staff capacity, food prices, monitoring systems, procurement policies, transport, finance procedures).

• Were some partners or programmes more efficient than others, if so why? • How could efficiency be improved?

40

Effectiveness: measures the extent to which an activity achieves its purpose or whether this can be expected on the basis of the outputs. Timeliness and coordination are examined under this criterion.

• To what extent have CAFOD and our partners achieved their goals and objectives? What are the main factors that have facilitated or constrained the achievement of these?

• Have the levels of success varied between partners? What are the reasons for this? • How timely were CAFOD and our partner’s responses? • How effective were CAFOD’s and our partner’s systems of ongoing analysis and

monitoring? • What are the different stakeholder’s views of the response? • To what extent did CAFOD co-ordinate with Caritas agencies, NGOs, partners,

donors, government? • To what extent were partners involved in field-based co-ordination mechanisms

(with other Caritas agencies, NGOs, the government and the UN), how effective were these?

• How successful has the response been in delivering assistance in accordance with humanitarian principles? (Including Code of Conduct, Sphere, Do No Harm, HAPI).

• How could effectiveness be improved? Impact: looks at the wider effects of the project (social, economic, technical and environmental) on individuals and groups (gender, age groups, communities and institutions). Impacts can be intended and unintended, positive, negative, macro (sector) and micro (household).

• Did CAFOD’s response have wider effects on individuals and groups (e.g. in relation to food prices, community coping strategies, regional food market structures, malnutrition rates and soil degradation)?

• Why did these impacts arise? • Have the impacts varied between partners, if so why? • How would the impact have been varied if CAFOD’s response was different? • How could the impact of the response be improved?

5. Intended users of the evaluation

• CAFOD, particularly the Humanitarian Support Department and the International Division management.

• Partners: CADEV (Caritas Niger), CRS, Islamic Relief • Caritas Internationalis International Cooperation Department

6. Key person specification

It is anticipated that the evaluation will be conducted by one individual who will have the following experience and skills: - Fluent written French and English

41

- Relevant experience of evaluating humanitarian aid programmes, especially food aid, food security and nutrition focused work - Relevant experience of working in humanitarian relief and development - Ability to analyse and synthesise in writing relevant information relating to humanitarian situations - Ability to work respectfully with national NGO partners Desirable:

- Experience of working with faith based agencies and faith based national NGOs 7. Evaluation methodology

Approach

The evaluator will propose the methodology for the evaluation, however it should: • Use international guidelines Sphere, the Red Cross Code of Conduct, and HAPI • Ensure good representation • Use participatory approaches and enable feedback from participants

Timeframe

It is anticipated that the evaluation will last around 3/4 weeks, with 3/5 working days in the UK at the beginning, up to 2 weeks of field visits, and 1 week of writing up the report, feedback, revisions and dissemination workshop. It is planned that the evaluation will commence during March 2007. Process

• Initial meeting in London to review background information to inform the assignment and to review proposed methodology

• Write-up methodology and timeline • Desk based review of key documents • Stakeholder meeting in UK (Interviews with UK based stakeholders including

CAFOD staff, Islamic Relief Head Quarters in Birmingham, other UK-based NGOs involved in the response to the Niger food crisis?

• Identify programme areas/partners to visit • Field visit – interviews/ focus group discussion with stakeholders: beneficiaries,

CADEV, CRS, Islamic Relief, NGOs, local government, and relevant co-ordination networks

• In-country presentation of preliminary findings to partners • Produce draft evaluation document • Presentation of draft report to CAFOD Humanitarian Support Department • Incorporation of comments received and preparation of the final report • Half-day workshop in CAFOD to present final findings

The report

The evaluation report should consist of: • Executive summary and recommendations (not more than five pages)

42

• Commentary and analysis addressing the issues raised in the TOR • Conclusions and Recommendations with a section dedicated to drawing out

specific lessons with suggestions for taking forward lessons learned (not more than 50 pages in all)

• Evidence for the beneficiary study • Appendices, to include evaluation terms of reference, maps, sample framework,

beneficiary research and bibliography. (All material collected in the undertaking of the evaluation process should process should be lodged with CAFOD prior to termination of the contract)

• The report and all background documentation will be the property of CAFOD (as the contracting organisation) and will be disseminated and publicised as appropriate by CAFOD.

8. Key reference documents

• Summary of CAFOD supported programmes in Niger • Meetings / Corporate Emergency Group meeting minutes • Project proposals and reports • Monitoring trip reports

9. Tenders Tender proposals should be submitted to: Philippe Mougin Humanitarian Support Department CAFOD Romero Close, Stockwell Road London SW9 9TY, UK Email: pmougin@cafod.org.uk Tel: +44(0)20 7733 7900 Direct line: +44(0)20 7095 5609 Fax: +44(0) 20 7274 1113 Cell: +44 (0)7766 725 493

Appendix II: Timetable of fieldwork in Niger

Date and

Time

Participants Purpose

April 23, 2007 at 14:00

Lisa Washington-Sow, Jasmine Bates, Hamani Harouna, Ali Abdoulaye, Sarah McKune, and Laura Donkin

Evaluator meeting with CRS/HKI key staff

April 23, 2007 at 17:00

Theophile Bansimba, Sarah McKune and Laura Donkin

Meeting with UNICEF nutritional representative

April 23, 2007 at 18:00

Raymond Yoro, Aissa Doro, Sarah McKune and Laura Donkin

Evaluator meeting with CADEV

April 24, 2007 Saley Boukari, Baguirbi Issa, Sidikou Meeting with CRS/HKI

43

Boukari, Mr. Awal Ibrahim, Hamani Harouna, Sarah McKune, and Laura Donkin

Regional Office in DogonDoutchi

Key informant interviews with agents de santés; focus groups with beneficiaries at each center

Site visit to Kieché, Mai Kalgo, Doutchi Nord, and the CRENI in Doutchi

April 25, 2007 Dr. Saley TCHINOMA, Ado ALZOUMA (MOH representative, Tanout), Laura Donkin, Hamani Harouna and Sarah McKune

Meeting with CRS/HKI Regional Office in Zinder

April 26, 2007 Key informant interviews with agents de santés and focus groups with beneficiaries at each center

Site visit to Tsamia CRENAM and Chirwa CRENAM

Hamani Haround, Sarah McKune, Laura Donkin, Awal Ibrahim, and two local doctors (Tanout based)

Meeting with Tanout District Hospital staff

Hamani Harouna and Sarah McKune Key informant interview HKI/CRS

April 27, 2007 Abdoulmoumouni Issa, Aissa Doro, Sarah McKune, and Laura Donkin

Meeting with CADEV Regional Office Maradi

Key informant interview with agent de santé and beneficiary focus groups at feeding centers, with cereal bank committee, and with recipients of animal distribution

Site visit to Maradi Brusse mobile CRENAM, and travel to Bermo. Site visit of TB center as well as Case de Santé.

April 28, 2007 Focus group discussion with femmes du relais and beneficiaries

Site visit to ambulatory CRENAM at one of the targeted nomadic sites

April 29, 2007 at 17:00

Jasmine Bates Key informant interview CRS

April 30, 2007 Ouedrago Housseini, Dr. Idrissa Maiga, Laura Donkin, Sarah McKune. Mrs. Aissa Doro (CADEV) and Abdou Adoumou met with the team at Dolbel.

Site visit to Foneko (IR), Dolbel (CADEV), and Chatoumane (IR); Feeding centers, failed and new well/pump sites, latrines

Prefect, IRN staff, Sarah McKune, and Laura Donkin

Courtesy visit to Prefect in Tera

Foneko Beneficiary focus group

Dolbel CRENAM staff Key informant interviews

Pere Emile, CADEV team Question and answer

Agent de santé, Rabiou Chaifou, Chatoumane

Question and answer

Well/pump management committee Chatoumane

Question and answer

May 1, 2007 Courtesy visit to mayor in Tillaberi

44

Agent de Santé, Sarah McKune, Laura Donkin

Key informant interview at Tillaberi District Hospital CRENI

Key informant interview with president of community health committee; focus group with five beneficiaries (women of children in CRENAM)

Site visit to Famale CRENAM, new well/pump

Key informant interview with agent de santé, question and answer with latrine management committee

Site visit to Kofouno

May 2, 2007 Prefect, Civil Service representatives, IR staff, Sarah McKune and Laura Donkin

Courtesy visit to prefect in Ouallam

Key informant interview, agent de santé Mme Hadiza Halidou and Head of CSI

Site visit Ouallam District hospital, CRENI

Four well repairmen/mechanics trained by IRN

Meeting in Simiri with team of four mechanics/well repairmen

At 17:30 Ali Abdoulaye and Sarah McKune Key informant interview CRS

At 19:00 Raymond Yoro and Sarah McKune Key informant interview CADEV

May 3, 2007 at 11:00

Andrea Hintzman, Laura Donkin, Sarah McKune

Key informant interview CADEV/CRS/Caritas Germany

May 4, 2007 Lisa Washington-Sow (CRS), Ali Abdoulaye (CRS), Hamani Harouna (HKI), Pierre Adou (HKI), Dr. Idrissa Maiga (IRN), Aissa Doro (CADEV), Abdou Adoumou (Niamey, CADEV)

Initial findings with partners

May 5, 2007 Sister Evelyn, Sister Lauren Site visit to Saga Center with Mme Doro. Key informant interviews with sisters

45

Appendix III: Partner Specific Feedback

III.1 CRS/HKI Feedback from CAFOD Evaluation

To assess effectiveness, CRS objectives are outlined in italics, with measurable indicators presented in the bulleted points below. These objectives are taken from CAFOD produced GAS documents for each funded grant. Subsequent bulleted (see arrows) points summarize realized outcomes for each indicator. These outcomes are taken largely from CRS generated end of project reports, unless otherwise noted. Strengths and weaknesses, based on document review and the evaluator’s field visit, are subsequently summarized. These data, in connection with overall effectiveness, are used to determine overall impact. Effectiveness

NIG008: The availability of food for households is increased.

• 28,978 households, or a total of 144,891 beneficiaries, to receive 100kgs of cereal, 8kgs of beans and 4kgs of vegetable oil that will be sufficient food for a 30-day period in communities where the food security situation was identified by the GoN as either critical or extremely critical food insecure ! The GAP for NIG008 indicated this as an objective, yet nowhere in CRS

reports does it appear that food distribution was funded through CAFOD. Instead, CRS indicates that CAFOD funded Vitamin A distribution to 6,000 children.34

NIG008: Severe malnutrition of children ages 0 to 59 months in Dogondoutchi and

Tanout is reduced

• 7,000 severely malnourished children are identified and brought to one of the 10 recuperation centers where they are treated according to the standards and procedures developed by the GoN in cooperation with UNICEF. ! 7070 malnourished children were identified and brought to one of the 10

recuperation centers; 89.8% of these were moderately malnourished children without medical complications; 92% of all admissions recovered through the treatment program.1

NIG010: Continue nutritional rehabilitation activities in 13 CRENAM/CRENAS (7 in

Doutchi and 6 in Tanout) and one CRENI in Doutchi district hospital.

• 13 CRENAM/CRENAS operational in the two districts and one CRENI operational in the district hospital in Doutchi. ! All 14 centers continued operation under CRS/HKI.35

NIG010: Open 2 new CRENAM/CRENAS centers in the south west of Doutchi.

• 2 new CRENAM/CRENA centers will be opened and functioning. 34 CRS CAFOD Final Narrative Report (27 9 2006) 35 CRS CAFOD Second Phase Final Report (12.02.07)

46

! 2 new centers opened in the southern area of the Department of Doutchi in February 2006.2

NIG010: To treat acutely malnourished children in these 16 structures.

• At least 85% of cases with severe and moderate malnutrition and health related problems are given adequate nutritional treatment ! No information is available through CRS reporting on the number of children

screened so to estimate coverage. • At least 90% of children suffering from malnutrition are cured

! 19,291 children were admitted to the nutritional programs in 16 centers; 17,789 (92%) were moderately malnourished without medical complications; 18,182 (94%) of all patients admitted recovered.36

NIG010: To promote responsibility of local partners for the conduct of nutritional

rehabilitation activities.

• Quality operating modalities defined in collaboration with local partners for the continuation of nutritional rehabilitation activities. ! Though not delineated through CRS reporting, field visits indicate that HKI

has worked closely with the GoN staff to integrate all efforts into existing systems, strengthening existing structures and systems to prepare for effective handover.

NIG010: To evaluate the efficiency of the nutritional centers.

! Centers monitored weekly by doctors and HKI Regional Coordinator; Centers submit monthly reports to Regional HKI Coordinator for CRENAM and CRENAS; CRENAM summary shows the monthly total of admissions disaggregated by gender and referrals from the CRENAS or CRENI, recoveries, deaths, drop-outs (those absent two consecutive weeks), non-respondents, and transfers to the CRENAS or CRENI; CRENAS/CRENI summary shares similar data - total admissions are disaggregated by cases of oedema and total referrals are those that graduate to the CRENAM; all data are used for a monthly analysis by the Regional Coordinators and are compiled into one report for monthly submission to CRS; HKI Regional Coordinator and centers are monitored on a monthly basis by HKI Nutrition Coordinator in Niamey and a quarterly basis by CRS Niamey staff.37

NIG010: To develop an educational/communications program for mothers to increase

their knowledge of nutritional rehabilitation and nutrition for infants.

• The start up and running of an educational program to bring better understanding to mothers about nutrition for children. ! No indication of an educational program occurring yet; educational efforts at

community level to be improved so that more families have access to nutrition information; a key objective of revised NNP is to train communities in the identification of malnutrition so that communities may refer their

36 CRS CAFOD Second Phase Final Report (12.02.07) 37 CRS CAFOD Second Phase Final Report (12.02.07)

47

children to a rehabilitation center; CRS/HKI’s proposed exit strategy has heath workers and communities trained according to the new protocol.38

NIG013: To extend nutritional rehabilitation in 9 CRENAM/CRENAS established in

Integrated Health Centres in Tanout district

! 9 new nutritional centers were established and opened in late September 2006 and will operate through December 2007.5

NIG013: To ensure that there is a functional CRENI in the Department of Tanout

! This objective was not met because, at the time, Hummanitarian Appeal International (HAI) was operating the CRENI out of the district hospital in Tanout; they have since left the project (December 2006) and CRS/HKI hope to reopen the clinic under the new CAFOD extension.5

NIG013: To ensure the nutritional treatment of at least 80% of acutely malnourished

children identified through a community approach.

! Though no screening or coverage data is available, 3,680 children were admitted to the nine centers between September and December 2006; 3,539 (96.2%) were moderately malnourished without complication; this report was completed in February 2007, thus trend data and recovery data were not yet available.5

NIG013: To raise awareness of health and nutrition among mothers of malnourished

children.

! No indication of an educational program occurring yet; educational efforts at community level to be improved so that more families have access to nutrition information; a key objective of revised NNP is to train communities in the identification of malnutrition so that communities may refer their children to a rehabilitation center; CRS/HKI’s proposed exit strategy has heath workers and communities trained according to the new protocol.39

Strengths, Weaknesses, and Impact

The major strengths of the CRS/HKI partnership lie in connectedness. CRS and HKI have demonstrated great success in working within existing infrastructure and systems, namely the national health system in Niger. CRS has trained GoN employed health agents at 25 health centers throughout Doutchi and Tanout districts according to GoN’s national protocol for the treatment of malnourished children under 5. The close collaboration and partnership with GoN will inevitably aid in the transition to hand over management of the centers to government operation by December 2007. Future focus areas for CRS/HKI should concentrate on communication, in a number of contexts. First, CRS/HKI should work with health workers to ensure feedback mechanisms are in place for grassroots ideas and change to arrive at CRS/HKI level.

38 CRS CAFOD Second Phase Final Report (12.02.07) 39 CRS CAFOD Second Phase Final Report (12.02.07)

48

During focus groups with beneficiaries and key informant interviews with health workers, individuals expressed ideas of how to ameliorate the current system, but questioned how to translate those messages into concrete change. As an example, it Tsamia, focus group participants recommended that those women and children who had traveled the furthest to participate in weekly CRENAM distribution be seen first. They had already raised the issue with the health agent, who was uncertain who had the power to make those decisions. Additionally, the decision to distribute weekly or biweekly should be a decision made at a center level, with support from HKI. Another area for improved communications is between CAFOD, CRS, and HKI. By having an intermediary, communications is sometimes slowed down, but information may also be misunderstood or lost. Especially regarding funding and implementation of programs, communication must be explicit so that implementation of activities on the ground is not delayed. Last, and perhaps most important, CRS/HKI must prioritize the development of a communications strategy. IEC materials, sessions, and programs must be included as an early component of the exit strategy. Increased education and mobilization is an essential element of decentralization of screening and treatment of malnutrition. The overall aims of the CAFOD funded CRS grants were: NIG008: To reduce the effect of the drought and locust attacks on the vulnerable households in Tanout, Dogondoutchi and Ouallam; NIG010: Continue with the treatment of children severely and moderately acutely malnourished to significantly reduce malnutrition, morbidity and mortality rates in children in the Dogondoutchi and Tanout areas of Niger; To gradually hand over the running of this activity to local partners and institutions; and NIG013: To contribute to a reduction of under-5 mortality using a medical and

community approach for the treatment of acutely severely and moderately malnourished

children.

Overall, CRS/HKI have had a positive impact on the communities they serve. They have targeted vulnerable populations and have been effective in improving the nutritional status of those that they have reached. The greatest area for improved impact is in developing a community approach to the treatment of malnutrition, including both improved decentralized screenings as well as trainings on community level treatment. Recommendations

Prioritize development of a communication strategy Increase community involvement and connectedness Delineate necessary actions for effective handover to GoN Streamline reporting and feedback mechanisms between CRS, HKI, and CAFOD Include CAFOD on monthly nutritional report to UNICEF (unanalyzed, raw data)

49

III.2 CADEV Feedback from CAFOD Evaluation

To assess effectiveness, CADEV objectives are outlined in italics, with measurable indicators presented in the bulleted points below. These objectives are taken from CAFOD produced GAS documents for each funded grant. Subsequent bulleted points (see arrows) summarize realized outcomes for each indicator. These outcomes are taken largely from CADEV generated end of project reports, unless otherwise noted. Strengths and weaknesses, based on document review and the evaluator’s field visit, are subsequently summarized. These data, in connection with overall effectiveness, are used to determine overall impact. Effectiveness NIG007: Extremely vulnerable individuals and communities in the worst affected areas have access to cereals.

• At least 80% of identified vulnerable households and communities have had access to cereals over 3 months. ! Overall, 350 villages were targeted and 1320 were served (377% of target);

81,000 individuals were targeted to benefit and 484,527 directly benefited (598% of target); coverage is not disaggregated for grain distribution v. disaster preparedness (see below), however based on targeted figures, it appears that effectiveness was good:

! FFW targeted distribution of 1275 MT of grain and achieved 992,601 MT for 77.9% achievement;

! Cereal Bank reconstitution targeted distribution of 250 MT and achieved 254.8 for 101.9% achievement;

! Subsidized sale of grain targeted distribution of 380 MT and achieved 397.5 for 104.6% achievement;

! Free distribution of grain was targeted at 374 MT and achieved 480.1 MT for 128.4% achievement; and

! Overall, the targeted distribution of grains was 2279 MT and 2125 MT were ultimately delivered, for total achievement of 93.2%.40

NIG007: Disaster preparedness among affected communities is enhanced by improving

water retention and soil conservation through food for work activities

• At least 80% of targeted communities embrace the disaster preparedness initiatives and complete the water retention and soil conservation works agreed. ! See overall coverage above; for disaster preparedness 880 hectares of land

were recuperated by construction of 266,675 (222% of target) demi- lunes and 189,725 mini water catchment pockets (zais) (0 were targeted); and 52,581 meters (117% of target) of rock ridges were built to increase rain retention into the soil.1

NIG011: To help the extremely vulnerable population by facilitating access food.

• Access to food will be facilitated for 80% of the victim population of the food crisis in the targeted villages.

40 Programme Aide Alimentaire d’Urgence, Rapport Finale, CADEV (Feb 2006)

50

! Unable to calculate coverage based on data provided: 292 villages benefited from FFW; 120 villages benefited from community grain bank efforts; 202 villages received free food distribution; 61 villages received subsidized food sales; for a total of 653,489 individual beneficiaries for the three interventions.41

NIG011: To develop adaptable mechanisms for vulnerable agricultural production

dependent on rainfall.

• At least 100 villages will benfit from the diversification of the production of the programme - 720 households will have developed activities to strengthen their adapted strategies to combat food insecurity. ! 51 villages benefited from income generating projects; 79 villages benefited

from off season gardening projects; and 99 villages benefited from puits maraichers, for a total of 229 beneficiary villages and 10,565 individual beneficiaries (average 7 per household = 1,509 households) for these three interventions. 2

NIG011: To contribute to the reduction of the rate of both acute and moderate

malnutrition in the zones of intervention of Caritas Niger.

• 12 supplementary feeding centers will function across the country - 15,000 children and 14,000 lactating and pregnant women will be treated in the medical and nutritional plan. ! 17,838 children under-five admitted to 12 CADEV operated feeding centers

throughout the country, with an overall recovery rate of 92.6%; data on the number of lactating and pregnant women are not included in the final report.2

Strengths, Weaknesses, and Impact

The greatest strength of CADEV’s projects is their connectedness to the communities they serve. By living in and working side by side with communities that benefit from their efforts, CADEV staff and volunteers operate in a context of trust and solidarity that is unique. This connected opens numerous doors and strengthens the project capacity at a local, community level. This strength has been tapped not only by CADEV, but by other organizations that recognize CADEV’s ability to quickly mobilize communities in times of need. Likewise, it affords CADEV the luxury of effective response to grassroot level concerns, ideas, and recommendations. Another of CADEV’s strengths is in its comprehensive nature of treatment. Specifically, CADEV is the only CAFOD partner that is currently effectively incorporating highly vulnerable adults into its nutritional programs. Future focus areas for CADEV should include coherence with the NNP and GoN structures, increased sensitization to accompany projects, and CSD professional capacity building. Protective and discharge rations are not permitted under the revised NNP except in the case on non-responsive patients. CADEV should develop a plan that

41 CADEV Rapport Narratif Final du Programme SOA 01/06 Réhabilitation des Communautés Apres Crise Alimentaire au Niger – Document Provisoire, Avril 2007

51

outlines how coherence with the NNP will be established as soon as possible. CADEV should seek out opportunities, where appropriate, to work with Civil Service and alongside GoN officials, despite continuing their nutritional efforts in parallel structures. Regarding sensitization, CADEV should ensure that beneficiary communities are sensitized to an intervention, targeting methodology, etc., prior to an intervention in order to prevent problems among beneficiaries and non-beneficiaries. This is true for FFW, Cereal Banks, as well as herd reconstitution and numerous other interventions. Last, there is enormous potential within the CSDs. CADEV should work closely with CAFOD to identify and then develop technical and professional capacity at this level. The overall aim of the CAFOD funded CADEV grants was that “extremely vulnerable

households and communities in the most food-deficit regions of Niger survive with dignity

through the current food crisis and are better prepared to withstand future emergencies”. Generally speaking, CADEV has had a very positive impact on the communities it serves. CADEV has targeted vulnerable populations and has been effective in improving access to food during and after the crisis, in improving the population’s adaptable mechanisms for vulnerable agricultural production, and in increasing the nutritional status of children under-five and vulnerable adults.

Recommendations

Train femme du relais to further increase decentralization of nutritional efforts Eliminate protective and discharge rations except in exceptional circumstances, according to NNP guidelines Explore creative ways to better integrate Civil Service and GoN into programs Identify priority capacity building areas in which CAFOD can support CSDs (such as project design, implementation, monitoring and evaluation) Include CAFOD on monthly nutritional report to UNICEF (unanalyzed, raw data)

52

III.3 IRN Feedback from CAFOD Evaluation

To assess effectiveness, IRN objectives are outlined in italics, with measurable indicators presented in the bulleted points below. These objectives are taken from CAFOD produced GAS documents for each funded grant. Subsequent bulleted points (see arrows) summarize realized outcomes for each indicator. These outcomes are taken largely from IRN generated end of project reports, unless otherwise noted. Strengths and weaknesses, based on document review and the evaluator’s field visit, are subsequently summarized. These data, in connection with overall effectiveness, are used to determine overall impact. Effectiveness

NIG009: To reinforce the capacities of 30 CSIs to deliver primary health care by

increasing close access to clean water supplies and increasing access to appropriate

hygiene and sanitation facilities

• Number of non-functional water supplies - boreholes and other water sources and systems – assessed. ! 3 failed attempts (2 in Foneko and 1 in Chatoumane)42

• Number of rehabilitated /repaired water supplies - boreholes and other water sources and systems. ! 11 non functional boreholes or other water sources rehabilitated, 10 at CSIs1

• Number of new boreholes drilled and equipped with hand/pedal pumps. ! 3 successful new boreholes equipped with hand/pedal pumps1

• Number of block-latrines constructed, used and kept clean. ! One 3-block latrine constructed in each of 4 communities at CSI (total of 4)1

NIG009: To reinforce community organisation with water and sanitation committees

• Number of functional water and sanitation management committees established. ! One at site of each new borehole, total of three (3) management committees.1 ! 26 existing water and sanitation committees reinforced1

• Number of water and sanitation management committee members attending to training sessions. ! 101 committee members have been trained in water management issues

through the Participatory Hygiene and Sanitation Transformation approach (PHAST).1

• Number of training sessions held ! Unknown

• Percentage of committees supply with tools box. ! Each of the new committees (3) have received a kit containing common spare

parts and a key for the regular repair and maintenance of new boreholes and pumps.1

• Number of mechanics trained. ! An existing network of 12 local mechanics has been reinforced and made

operational.1

42 IRN Final Report CAFOD Funded Watsan Project 120307

53

! 12 mechanics have been trained in repair and maintenance of the Vergnet-designed pedal pump and Volunta-designed hand pump (used in 90% of wells in the region).43

NIG009: To promote hygienic practices of community members in order to reduce

instance of water-based diseases in the targeted communities.

! No documented evidence presented in final report. However, community and beneficiary discussions during field visits indicate greater consumption and use of water, and a reported increase in hygiene among children observed by some health workers.

NIG012: To reduce global acute malnutrition by 70% respectively in four districts of

Tillaberi region (Tillaberi, Tera, Ouallam, and Filingue)

• Number of malnourished children, pregnant and lactating women who have received food. ! Four (04) existing CRENI are equipped and made fully operational: with a

recovery rate of 88% and mortality rate of 10.6%.44 ! 34 existing CRENAM/CRENAS are equipped and made fully operational,

with a recovery of 81% and a mortality rate of 0.4%.3 ! Total of 50,430 children admitted45 ! Lactating and pregnant women were ultimately not included in the nutritionl

program.3 NIG012: To increase the access to improved heath services for 10,000 malnourished

children, 8,000 mothers of malnourished children and 14,000 pregnant and lactation

mothers (free consultation by trained health workers and free medicine)

• Percent of malnourished children and their mothers, lactating and pregnant women who received free health care ! This data is not included in final reporting to CAFOD. CAFOD has requested

that all information on the project be presented, not only for the portion CAFOD has funded.

NIG012: To reinforce the health/nutrition information system in 35 health centres;

• Number of Community Health Centres reporting to the national information system; ! Four (4) CRENI and 34 CRENAM/CRENAS regularly report nutritional

data.3

NIG012: To raise the community awareness regarding malnutrition to the extent that

60% of the communities in the targeted area will be able to list three causes of

malnutrition and three means of prevention.

43 IRN Final Report CAFOD Funded Watsan Project 120307 44 IRN CAFOD Nutrition Completion Report Sample 12-03-07 45 IRN One Page Sheet Nutritional Data, acquired during CAFOD Evaluation field visit

54

• Percent of community members who are able to list/tell at least three causes and three measures of prevention of malnutrition ! This data is not included in final reporting to CAFOD.

• Number of Nurses/Doctors able to analyse data and adapt treatment accordingly. ! This data is not included in final reporting to CAFOD.

Strengths, Weaknesses, and Impact

The IRN projects oulined above are well integrated into the GoN’s existing infrastructure, as well as well connected to existing NGO and community structures. The geographic and programmatic focus of IRN’s projects has afforded them increased impact. Communities are benefiting from reinforced water, sanitation, health and nutritional components, all of whose effects are synergistic. IRN has demonstrated solid collaboration with officials within the national health system, and has collaborated in a very flexible manner with other international NGOs and existing local groups. Examples include collaboration with Plan International for CSI management and collaboration/training of existing well mechanics and water/sanitation committees. This flexibility and spirit of collaboration are a strength of IRN. Future focus areas for IRN should include improved reporting, decentralization of nutritional screening and treatment, and inclusion of vulnerable adult populations in nutritional programs. IRN’s reporting to CAFOD should include all aspects of the program, as were submitted in the original project proposal. Included therein should be sufficient data so that CAFOD can compare achievements against standards set out in the original project proposal; examples of such needed data include the number of individuals receiving free health care, rates of GAM, and the number of individuals with awareness of how to prevent malnutrition. These are only examples but represent the type of data required for project evaluation. (Note: It is the understanding of the CAFOD evaluator that an IRN project evaluation has also taken place; this document may answer some of the concerns expressed here). Reporting of nutritional data needs to be streamlined. Raw numbers are not available through existing reports and percentages to not logically add up. CAFOD and the evaluator have requested detailed information in order to fully assess the achievements of the nutritional program. Last, in order to successfully hand over nutritional programs to the GoN, a decentralization of nutritional screening and community education on community treatment of malnutrition must be implemented. This is an objective of the GoN, and efforts towards this end should begin now, as IRN is well positioned to lead this effort. The overall aims of the CAFOD funded IRN grants were: NIG009: To contribute to the improvement of the health environment of 30 Integrated

Primary Health Centres and its surrounding community by increasing close access to

clean water sources and appropriate hygiene and sanitation facilities.

NIG012: To provide the malnourished children and their families with immediate, free

access to quality health services, and supplementary and therapeutic feeding

programmes throughout the four districts of the Tillaberi Region; to establish sustainable

55

and effective nutrition surveillance and the response capacity systems for intervention at

the hospital level in the Tillaberi region; and to increase nutrition awareness amongst

the population in the Tillaberi region.

Generally speaking, IRN has had a very positive impact on the communities it serves, particularly those who have benefited from new water sites. IRN has followed Sphere guidelines to target vulnerable populations. IRN has been effective in improving access to water and appropriate hygiene/sanitation facilities in beneficiary communities and in improving the health status of malnourished children in the Tillaberi region. Further information is required to nutritional

Recommendations

Pregnant and lactating mothers should be included in screening and treatment of malnutrition Expedite establishment and training of community health committees for each CSI Expand current reporting to CAFOD to include data on entire project Include CAFOD on monthly nutritional report to UNICEF (unanalyzed, raw data)