2. Introduction

A description of the sector and the study,

Providing the reader with sufficient methodological explanations to gauge the credibility of the con -clusions and to acknowledge limitations or weaknesses, where relevant.

This report contains results of the end-term review (ETR) of the Support to Improved Nutrition Status of Vulnerable Groups in Malawi (SINSM) carried out from the 26 th of October till the 20th of November 2015. The SINSM programme was a pilot programme implemented by the Department of Nutrition and HIV and AIDS (DNHV) jointly with the line Ministry of Health (MOH), the Ministry of Ag -riculture and Food Security (MOAFS), the Ministry of Gender (MOG) and the Ministry of Education (MOE) and also with the NGO’s “Welthungerhilfe” (WHH) and the Foundation for Irrigation and Sus -tainable Development (FISD).

The programme consisted of two (2) Programme Estimates (PE): PE1 from 01/02/2011 – 30/09/2012 and PE2 from 01/11/2012 – 31/10/2014. Each PE had five (5) Result Areas (RA): 1) Support to nutri -tional products distribution to vulnerable groups (PE1) and Support to school meals programme (PE2); 2) Strengthen capacity in nutrition for the communities and other stakeholders; 3) Nutrition Surveillance System strengthened to enable tracking of malnutrition for timely and rational re-sponse; 4) Capacity of health facilities to manage nutritional rehabilitation improved and 5) Project coordination and management activities improved. In PE21 two (2) Grants of each € 750,000 (+ € 172,000) were allocated to WHH2 and FISD3 for the school feeding programme.

The programme’s total allocated amount through two (2) MOU was € 7,650,000. Under PE1 + 48% of the total budget was absorbed and under PE2 + 77%. The DNHA used € 4,840,000 and the Grants for school feeding € 1,500,000 and an extra Grant for CBS of € 172,000 was allocated. Therefore the ex-penditure for the whole SINMS (2011-2014) was € 4,840,000 + € 1,500,000 + € 172,000 = € 6,510,000. This is 85% of the total allocated amount.

The SINSM programme was implemented in ten (10) Districts in Malawi. It aimed to contribute on the improvement of the nutritional status of all Malawians with special emphasis on vulnerable groups such as pregnant and lactating women, children below the age of 5 years, both school aged and school going children, orphans and people living with HIV and AIDS through improved service delivery systems in 10 selected Districts. In each district the SINSM had a food and nutrition focal point: one in the District’s Health Office and one in the District’s Agriculture Development Office. The school feeding programme was implemented by the District’s Education Management (DEM) Office through the DEM education health and nutrition officer.

The two main purposes of this ETR were according to the Terms of Reference (annex 1):

1 The expenditure for the two Grants €1,500,000 were under Special Commitment and not included in the PE2 expenditure summary. The School Meals Programme also benefited on a Supply Contract for Corn Soya Blend (CBS) – value €172,000 (source: NAO). 2 Supporting improved nutrition and health and building institutional capacity for sustainable home grown school meal programmes in Malawi' (01/01-31/12/14). 3 Sustainable School Meals Initiative (SSMI) (01/01-31/12/14).

1. To make an overall independent assessment about the performance of the SINSM paying partic-ular attention to analysis of relevance, efficiency, effectiveness, impact, sustainability, coherence and the EU added value of the programme.

2. Analysis of substantial conclusions on the feasibility of the programme design and the imple-mentation for reaching the stated objectives.

The first period of the ETR was an inception period during the first week (26-30 October 2015) that was followed by an inception meeting on the 2nd of November with the EUD, NAO, DNHA, MOH, MOAFS etc. An official inception report was sent to the EUD in which the methodology of the ETR was more detailed and a detailed work plan was presented. The second and third week of the as -signment was used to visit the ten (10) Districts in which the SINSM was implemented 4. The field vis-its took place from Monday the 2nd of November till Friday the 13th of November, during the field visit only 9 Districts were visited. All the implementing partners5 were extensively interviewed. De-pending on the results of the implementation, visits to health facilities, schools and eventually in -volved communities were planned depending on available time, distances and available beneficiaries etc. Each visit to a District started with a visit to the District’s Council office where the District Com -missioner was officially informed about the objective of the visit and also the District’s Planning Dir -ector. All questions related to the service implementation of the SINSM and the SINSM’s Surveillance system but also the backstopping from the DNHA were intensively assessed and based on the an-swers complementary field visits to health facilities and involved schools were planned. Of each visit to a District the ETR-team made a final District’s Assessment Fiche in which main findings and results were capitulated. In a general impressions part the overall findings were described in a concisely way (see annex 7.5). The fourth week 16-20th of November was used for writing of the aide mem-oire, debriefing and a final validation workshop in which all partners on Central and District’s level participated. The workshop aimed at presenting the findings of the ETR to the main stakeholders, to check the factual basis of the evaluation and to discuss the draft findings, conclusions and recom-mendations made by the ETR-team.

The Terms of Reference (TOR) for this ETR detail in part 2.3 the requested services in five (5) points. Each point has a bulleted number of “guidelines” to concentrate and to answer on if evidence based information is available.

This ETR was constrained by the simple fact that ten (10) of the implicated Districts were requested to be visited while only nine (9) effective days were only available. Therefore workdays of more than 8 hours were mainly used for long distance travels and interviews. Most District’s services have an official working hours from 7.30 AM – 4.00 PM. This was also the case for the schools and the health facilities. Another constraint was that in a number of Districts involved staff members of Govern -ment services were new and never involved in the SINSM’s that ended up in October 2014. Since there has never been a central coordination entity on Districts level no district’s institutional memory was in place.

It is requested in the TR to provide the reader with sufficient methodological explanations to gauge the credibility of the conclusions and to acknowledge limitations or weaknesses, where relevant. This can be done once we have analysed the optimal implementation of the programme on condi -

4 Nkhatabay, Rhumpi, Dowa, Salima, Mangochi, Phalombe, Chikhwawa, Chiradzulo, Neno, Dedza5 District Agriculture Development Office (DADO), District Nutrition SINSM focal point, District Education SINSM focal point, District M&E officer.

tion that the DNHA supplied optimal support to the Districts. It also means that if the Districts were in a position to support the sentinel sides or APE in an optimal way and a good working surveillance system, the nutritional status of the vulnerable groups in these sites would have been improved sub -stantially. The methodology to work and assess these situations must although be found out during the visits to the Districts. If the Districts and also the DNHA were in a position to provide clear data on the nutritional and the food security status in the concerned Districts, the assessment could point out whether the programme was able to meet its objectives. If not or partially done as was planned, the ETR has to find out why. The programme was, however, a kind a pilot or test programme to find out whether the proposed activities were able to improve the food and nutrition security status of the proposed vulnerable groups. If these data are not more available the relevance, the efficiency, the effectiveness, the impact and certainly the sustainability and the coherence cannot be assessed in an objective way.

In annex 7.6 the results and recommendations made during the 2008 final evaluation of the ACF-UK managed and implemented are listed in a concise way. It is important to know how the first emer-gency food and nutrition security surveillance system performed and what the recommendations were how to implement the developed system by the GOM.

Important sources were also the PE1 and PE2 official documents and the two (2) final progress re -ports. In the PE1 the Human Resources that were made available for this programme were explained but also the “ORGANOGRAM” (organisational chart) of the PE1and, the role of the steering commit -tee and the organisation at District level were explained (see annex 7.7).