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JSI Research & Training Institute, Inc. (JSI) * Helen Keller International (HKI) * International
Food Policy Research Institute (IFPRI) * Save the Children (SC) * The Manoff Group (TMG)
Quarterly Report
Jan 1, 2013 – March 31, 2013
Cooperative Agreement Number: AID-OAA-A-11-00031
(May 15, 2013)
The Strengthening Partnerships, Results and Innovations in Nutrition Globally (SPRING) Project
is supported by the United States Agency for International Development (USAID) under
Cooperative Agreement No. AID-OAA-A-11-00031. SPRING is managed by JSI Research &
Training Institute, Inc.
1
I. Quarter 2 Highlights
Highlights for SPRING’s Quarter 2, 2013 reporting are presented below.
Core highlights
• SPRING presented an NCD simulation model to senior USAID management. The model included
work on a cost function for public health provision in developing countries and an
epidemiological transition model. In addition, SPRING posted a set of country briefs on
nutrition-related NCDs on its website
• The project staff finished the three agriculture and nutrition global learning and evidence
exchanges (AgN-GLEEs). During the quarter, USAID’s Bureau for Food Security invested SPRING
to assist both Washington and missions incorporate nutrition into Feed the Future.
• Digital Green (DG) is reaching target audiences with BCC materials and IFPRI has done
preparatory work for its evaluation of the DG methodology
• Four IFA briefs were finished this quarter and another seven will be published in the third
quarter
• SPRING finalized a contract this quarter to work with an experienced anemia expert, Phil Harvey,
to develop an overall anemia strategy for the project.
• The project staff created a range of tools for NACS programming, including guides for
interviewing at facilities and with clinics directors and health care providers.
• SPRING is working with the Ugandan government on a multiple micronutrient powder (MMPs)
pilot project. This quarter a protocol was developed and discussions were under way to partner
with the Ugandan government and the World Food Program in quarter 3.
• The project staff is collaborating with REACH in Uganda on a “Pathways to Better Nutrition” case
study. SPRING has developed national level interview tools and will collect baseline data in the
3rd quarter.
• SPRING continues to work with fortification, including completing a research protocol to assess
feasibility of scaling up home fortification in Uganda and writing a paper on maize meal
fortification in Kenya, Uganda and Zambia. Project staff will participate in WHO Technical
Collaborations to update staple food fortification documents.
• Other activities this quarter included a Peace Corps training of trainers in essential nutrition
actions for five West African countries, collaboration with the SUN CSO Network and assistance
to SUN on two national nutrition guidelines.
Country highlights
• Bangladesh – Project staff are now working in 40 upazillas in Khulna and Barisal states, including
1,301 farmer field schools with more than 29,000 participants. The project has trained almost
5,000 Government of Bangladesh health and agriculture staff in essential nutrition and hygiene
actions (ENHA), representing almost 150% of the projects goal.
• Haiti – SPRING developed training packages, conducted a NACS nutrition assessment at health
facilities, implemented anthropometric trainings to health personnel and began a series of
reinforcement visits to ensure regular updates of staff skills.
• Nigeria – The project team concentrated on training and distribution of the national and
community IYCF training guidelines. The project will expand NACS within Nigeria in the third
quarter.
2
• Uganda – SPRING disseminated the results from the SPRING-led assessment of NACS services in
health facilities in SW Uganda, provided technical support to the MOH in developing and pre-
testing a NACS training package for facility-based health providers, developed workplans for
activities related to the Partnership for HIV-Free Survival (PHFS) and implemented NACS
activities in southwestern Uganda health facilities.
3
II. A
ctiv
ity
Ma
trix
A
ctiv
ity
Nu
mb
er
Act
ivit
y N
am
e
Act
ivit
y u
pd
ate
s/st
atu
s in
clu
din
g n
ext
ste
ps
1
.1
Dri
vers
an
d b
arr
iers
to
sca
ling
up
ke
y n
utr
itio
n
inte
rve
nti
on
s d
ocu
me
nte
d a
nd
dis
sem
ina
ted
SPR
ING
un
de
rto
ok
a b
ackg
rou
nd
re
vie
w o
f co
un
trie
s w
ith
a h
igh
-bu
rde
n o
f st
un
tin
g to
un
de
rsta
nd
th
eir
pro
gre
ss in
imp
lem
en
tin
g a
pa
ckag
e o
f n
utr
itio
n in
terv
en
tio
ns
to
imp
rove
min
imu
m a
cce
pta
ble
die
ts a
mo
ng
ch
ildre
n 6
to
23
mo
nth
s. T
he
ba
ckgr
ou
nd
revi
ew
ind
ica
ted
th
at,
de
spit
e t
he
eff
ica
cy o
f va
rio
us
hig
h-i
mp
act
in
terv
en
tio
ns
to
imp
rove
co
mp
lem
en
tary
fe
ed
ing
am
on
g ch
ildre
n 6
-23
mo
nth
s, r
ela
tive
ly f
ew
co
un
trie
s
ha
d d
ata
sets
on
imp
lem
en
tin
g a
co
mp
reh
en
sive
pac
kag
e t
o s
tre
ng
the
n c
om
ple
me
nta
ry
fee
din
g p
ract
ice
s a
t sc
ale
du
rin
g t
he
1,0
00
da
ys p
eri
od
. W
e a
re c
urr
en
tly
exp
lori
ng
alt
ern
ati
ve a
pp
roa
che
s to
an
swe
rin
g th
ese
qu
est
ion
s.
1.2
A
dvo
cate
fo
r sc
ale
up
of
Mat
ern
al, I
nfa
nt
an
d
Yo
un
g C
hild
Fe
ed
ing
(M
IYC
F) p
rog
ram
s
a.
Use
up
com
ing
20
13
glo
ba
l nu
trit
ion
eve
nts
to
bu
ild
mo
me
ntu
m f
or
MIY
CN
SPR
ING
ha
s m
ad
e s
ign
ific
an
t p
rog
ress
wit
h a
rra
ngi
ng
the
par
alle
l se
ssio
n a
nd
sa
tell
ite
sym
po
siu
m a
t th
e I
UN
S m
ee
tin
g.
SP
RIN
G w
ill c
on
tin
ue
to
fin
aliz
e t
he
logi
stic
s fo
r th
ese
sess
ion
s d
uri
ng
th
e n
ext
qu
art
er.
SP
RIN
G s
ub
mit
ted
a n
um
be
r o
f a
bst
ract
s fo
r th
e
up
com
ing
IUN
S co
nfe
ren
ce in
Gra
na
da
, Sp
ain
in S
ep
tem
be
r 2
01
3.
All
ab
stra
cts
we
re
acc
ep
ted
as
po
ste
r p
rese
nta
tio
ns.
b.
SPR
ING
will
fo
ste
r a
nd
su
pp
ort
IY
CF
ad
voca
cy
to a
dva
nce
nu
trit
ion
sca
le-u
p i
n s
ele
ct S
PR
ING
cou
ntr
ies
SPR
ING
is
rou
tin
ely
en
ga
gin
g in
ad
voca
cy a
s w
e m
ove
co
un
try
pro
gra
m a
gen
da
s fo
rwar
d.
For
exa
mp
le,
SPR
ING
ha
s b
ee
n a
ctiv
ely
in
volv
ed
in S
UN
-re
late
d l
aun
ch a
ctiv
itie
s in
Ug
an
da
an
d N
ige
ria
. SP
RIN
G is
cu
rre
ntl
y in
th
e p
roce
ss o
f d
eve
lop
ing
furt
he
r gl
ob
al
ad
voca
cy a
ctiv
itie
s.
1.3
Fea
sib
ility
ass
ess
me
nt
of
fort
ific
ati
on
in
ke
y
cou
ntr
ies
Ne
xt q
uar
ter,
SP
RIN
G w
ill p
art
icip
ate
in a
WH
O T
ech
nic
al C
on
sult
ati
on
on
mai
ze m
ea
l
fort
ific
ati
on
in
Ne
w Y
ork
du
rin
g A
pri
l 8-9
an
d p
rese
nt
“Ma
ize
Me
al F
ort
ific
ati
on
: M
arke
ts,
Fea
sib
ility
an
d C
ost
s. E
vid
en
ce f
rom
Ke
nya
, U
ga
nd
a a
nd
Zam
bia
.” P
ap
ers
by
the
pre
sen
ters
will
be
pu
bli
she
d in
th
e A
nn
als
of
the
Ne
w Y
ork
Aca
de
my
of
Scie
nce
s.
WH
O i
s u
pd
ati
ng
seve
ral e
vid
en
ce-i
nfo
rme
d g
uid
eli
ne
s fo
r th
e f
ort
ific
ati
on
of
sta
ple
foo
ds
as
a p
ub
lic h
eal
th in
terv
en
tio
n.
SP
RIN
G w
ill p
art
icip
ate
in
up
com
ing
WH
O
Te
chn
ical
Co
nsu
lta
tio
ns,
wh
ich
will
cu
lmin
ate
in W
HO
-iss
ue
d m
aize
flo
ur
an
d c
orn
me
al
fort
ific
ati
on
gu
ide
line
s.
1.4
C
oo
rdin
ati
on
pla
tfo
rms
to s
tre
ng
the
n g
lob
al a
nd
na
tio
na
l act
ion
s fo
r a
ne
mia
co
ntr
ol
SPR
ING
pa
rtic
ipa
ted
in
tw
o a
ne
mia
ta
sk f
orc
e m
ee
tin
gs
du
rin
g t
he
re
po
rtin
g p
eri
od
. T
he
term
s o
f re
fere
nce
fo
r th
e a
ne
mia
ta
sk f
orc
e w
as
de
velo
pe
d a
nd
fin
aliz
ed
. T
he
me
eti
ng
s
4
h
ad
wid
e p
art
icip
ati
on
fro
m U
SAID
an
d U
nit
ed
Sta
tes
Go
vern
me
nt
(USG
) p
artn
ers
wo
rkin
g in
ne
gle
cte
d t
rop
ica
l dis
ea
ses,
nu
trit
ion
, mal
ari
a,
agr
icu
ltu
re,
an
d f
oo
d
ass
ista
nce
pro
gra
ms.
2.1
Do
cum
en
tati
on
an
d p
rogr
am
gu
ida
nce
on
eff
ica
cio
us
SBC
C a
pp
roac
he
s fo
r im
pro
ved
nu
trit
ion
Du
rin
g t
his
qu
art
er,
th
e S
BC
C li
tera
ture
re
vie
w t
eam
he
ld a
Bro
wn
Bag
Lu
nch
to
so
licit
fee
db
ack
fro
m t
he
larg
er
SPR
ING
te
am r
eg
ard
ing
th
e s
tru
ctu
re a
nd
pre
sen
tati
on
of
resu
lts
fro
m t
he
lite
ratu
re r
evi
ew
. T
he
te
am
ha
s co
mp
lete
d a
ll se
arc
he
s a
nd
th
e
ext
ract
ion
of
key
info
rma
tio
n f
rom
se
lect
ed
jo
urn
al a
rtic
les.
In
to
tal,
SP
RIN
G h
as
no
w
revi
ew
ed
19
,74
8 s
ea
rch
re
sult
s a
s in
dic
ate
d b
elo
w:
• M
ate
rnal
die
tary
: 3
,60
6 s
ear
ch r
esu
lts,
14
ext
ract
ed
art
icle
s
• B
rea
stfe
ed
ing
: 3
,92
2 s
ea
rch
re
sult
s, 7
0 e
xtra
cte
d a
rtic
les
• C
om
ple
me
nta
ry f
ee
din
g:
5,4
97
se
arc
h r
esu
lts,
39
ext
ract
ed
art
icle
s
• P
reve
nti
on
an
d c
on
tro
l of
mic
ron
utr
ien
t d
efi
cie
nci
es:
2,8
22
se
arc
h r
esu
lts,
56
ext
ract
ed
art
icle
s
• W
ASH
: 3
,90
1 s
ea
rch
re
sult
s, 2
2 e
xtra
cte
d a
rtic
les
Ne
xt q
uar
ter,
SP
RIN
G w
ill f
inal
ize
th
e r
ep
ort
an
d p
ost
fin
din
gs
on
th
e in
tern
et.
2.2
Fe
asi
bili
ty s
tud
ies
rela
ted
to
inn
ova
tive
SB
CC
ap
pro
ach
es
for
imp
rove
d n
utr
itio
n p
ract
ice
s a
nd
ou
tco
me
s
a.
Ad
ap
tin
g th
e D
igit
al G
ree
n a
pp
roa
ch t
o
pro
mo
te i
mp
rove
d m
ate
rnal
, in
fan
t a
nd
yo
un
g
chil
d n
utr
itio
n (
MIY
CN
) a
nd
hyg
ien
e p
ract
ice
s a
t
the
ho
use
ho
ld l
eve
l
Th
e S
PR
ING
/Dig
ital
Gre
en
co
lla
bo
rati
on
ach
ieve
d g
rea
t p
rogr
ess
in
th
e s
eco
nd
qu
arte
r
wit
h t
he
fin
aliz
ati
on
of
ma
teri
als
an
d r
ollo
ut
of
the
Ma
tern
al I
nfa
nt
an
d Y
ou
ng
Ch
ild
Co
mm
un
ity
Nu
trit
ion
Tra
inin
g in
Ke
on
jhar
Dis
tric
t, O
dis
sa.
This
tra
inin
g s
erv
ed
to
bu
ild
cap
aci
ty in
MIY
CN
of
the
loca
l p
rogr
am
sta
ff a
nd
to
se
nsi
tize
th
em
to
th
e c
ha
llen
ge
s a
nd
op
po
rtu
nit
ies
wit
hin
nu
trit
ion
pro
gra
mm
ing
. P
eg
gy K
on
iz-B
oo
he
r, S
en
ior
Nu
trit
ion
an
d
SBC
C a
dvi
sor
for
SPR
ING
, att
en
de
d t
he
tra
inin
g, f
inal
ize
d t
he
fo
rma
tive
re
sear
ch a
nd
ass
iste
d w
ith
th
e d
eve
lop
me
nt
of
a p
relim
ina
ry t
est
vid
eo
on
nu
trit
ion
. T
ow
ard
s th
e e
nd
of
the
qu
arte
r, K
rist
ina
Be
all,
SBC
C P
roje
ct O
ffic
er,
als
o t
rave
led
to
Od
issa
to
pro
vid
e
foll
ow
-up
te
chn
ical
ass
ista
nce
an
d s
up
po
rt f
or
the
cre
ati
on
of
the
fir
st s
et
of
nu
trit
ion
vid
eo
s a
s w
ell
as
sup
po
rt t
he
vis
it b
y IF
PR
I to
ass
ess
th
e s
cop
e o
f th
e S
PR
ING
/Dig
ital
Gre
en
Fe
asi
bili
ty S
tud
y a
nd
in
itia
l p
roto
col
de
velo
pm
en
t d
iscu
ssio
ns.
Ne
xt q
uar
ter,
SP
RIN
G w
ill f
inal
ize
th
e v
ide
o d
esi
gn
an
d p
rod
uct
ion
re
vie
w p
roce
ss a
nd
the
M&
E p
lan
in
ord
er
to b
eg
in v
ide
o d
isse
min
ati
on
s.
b.
Ide
nti
fyin
g a
tar
ge
ted
mH
ea
lth
in
no
vati
on
focu
sed
on
pro
mo
tin
g c
om
ple
me
nta
ry f
ee
din
g
pra
ctic
es
in o
ne
or
mo
re s
ele
cte
d S
PR
ING
cou
ntr
ies
SPR
ING
co
nti
nu
ed
co
nd
uct
ing
ba
ckg
rou
nd
re
sea
rch
, co
nsu
lta
tio
ns
wit
h e
xpe
rts
(e.g
.
Joh
ns
Ho
pki
ns,
D-T
ree
, UN
ICE
F, A
live
& T
hri
ve,
JSI,
MC
HIP
), a
nd
pa
rtic
ipa
tin
g in
va
rio
us
mH
eal
th w
ork
ing
gro
up
s to
fo
rmu
late
th
e S
PR
ING
mH
eal
th s
tra
teg
y. T
his
bac
kgro
un
d
revi
ew
cu
lmin
ate
d i
n a
n i
nte
rnal
pre
sen
tati
on
syn
the
sizi
ng
the
fin
din
gs
an
d p
rop
osi
ng
key
pri
nci
ple
s a
nd
po
ten
tial
op
po
rtu
nit
ies
for
en
ga
ge
me
nt.
Ne
xt q
uar
ter
SPR
ING
will
con
tin
ue
co
nve
rsa
tio
ns
wit
h i
nte
rnal
sta
keh
old
ers
an
d p
ote
nti
al e
xte
rna
l pa
rtn
ers
to
de
velo
p a
str
ate
gy,
an
d t
o d
raft
a c
on
cep
t n
ote
su
mm
ari
zin
g th
e p
rop
ose
d w
ork
.
5
3.1
St
ren
gth
en
na
tio
nal
pro
gra
ms
to r
ed
uce
th
e
pre
vale
nce
of
an
em
ia
a.
An
alys
is o
f IF
A p
rovi
sio
n a
nd
co
nsu
mp
tio
n
acr
oss
hig
h-b
urd
en
co
un
trie
s
In a
dd
itio
n t
o f
ive
IFA
co
un
try
case
stu
die
s p
ub
lish
ed
last
qu
art
er,
se
ven
ad
dit
ion
al
stu
die
s o
f th
e d
istr
ibu
tio
n o
f IF
A t
hro
ugh
an
ten
ata
l car
e p
rog
ram
s w
ere
co
mp
lete
d a
nd
are
un
de
r re
vie
w in
clu
din
g C
am
bo
dia
, D
RC
, H
ait
i, K
en
ya,
Ne
pa
l, T
an
zan
ia a
nd
Ug
an
da.
b.
Te
chn
ica
l ass
ista
nce
to
str
en
gth
en
th
e
imp
lem
en
tati
on
of
Ug
an
da
’s in
tegr
ate
d
mic
ron
utr
ien
t p
olic
y w
ith
a f
ocu
s o
n c
hild
an
em
ia
A r
ese
arch
pro
toco
l wa
s d
eve
lop
ed
to
ass
ess
th
e f
ea
sib
ilit
y o
f sc
alin
g u
p h
om
e
fort
ific
ati
on
in
se
lect
ed
dis
tric
ts o
f U
gan
da
last
qu
arte
r. T
he
fin
din
gs
of
the
stu
dy
will
be
use
d t
o in
form
th
e m
icro
nu
trie
nt
po
licy
on
ch
ild a
ne
mia
in U
ga
nd
a.
Ple
ase
re
fer
to
act
ivit
y 3
.2 f
or
ad
dit
ion
al i
nfo
rma
tio
n.
3.2
T
ech
nic
al a
ssis
tan
ce o
n in
tro
du
ctio
n a
nd
use
of
Mu
ltip
le M
icro
nu
trie
nt
Po
wd
ers
(M
MP
) to
imp
rove
co
mp
lem
en
tary
fe
ed
ing
Du
rin
g t
his
qu
art
er,
SP
RIN
G d
eve
lop
ed
a r
ese
arc
h p
roto
col
to a
sse
ss t
he
fe
asi
bili
ty a
nd
com
pli
an
ce w
ith
ho
me
fo
rtif
ica
tio
n in
se
lect
ed
dis
tric
ts o
f U
ga
nd
a.
Th
e m
ain
re
sear
ch
qu
est
ion
s fo
r th
is w
ork
in
clu
de
:
• W
ha
t a
re t
he
cu
rre
nt
com
ple
me
nta
ry f
ee
din
g p
ract
ice
s am
on
g c
hild
ren
6-2
3
mo
nth
s o
f ag
e in
Ug
an
da
? (
de
sk r
evi
ew
– U
DH
S a
nal
ysis
)
• W
ha
t is
th
e c
urr
en
t le
vel
of
care
take
rs’
kno
wle
dg
e,
att
itu
de
s, p
ract
ice
s a
nd
be
ha
vio
rs r
eg
ard
ing
th
e u
se o
f h
om
e f
ort
ific
ati
on
of
com
ple
me
nta
ry f
oo
ds
of
chil
dre
n 6
-23
mo
nth
s
• W
ha
t a
re t
he
ma
in b
arri
ers
(am
on
g m
oth
ers
/ca
reta
kers
, h
ea
lth
wo
rke
rs,
com
mu
nit
y co
ord
ina
tors
an
d o
the
rs)
to t
he
ap
pro
pri
ate
use
of
ho
me
fort
ific
ati
on
wit
h M
MP
?
• W
ha
t a
re s
om
e o
f th
e a
ttra
ctiv
e f
eat
ure
s o
f M
MP
? W
ha
t sh
ou
ld b
e f
ea
ture
d in
SBC
C m
ess
agi
ng
?
• W
ha
t w
ou
ld p
eo
ple
be
will
ing
to p
ay
(if
ap
plic
ab
le)?
• W
ha
t is
th
e m
ost
re
alis
tic
dis
trib
uti
on
sch
ed
ule
in t
erm
s o
f n
um
be
r o
f co
nta
cts
an
d a
mo
un
t o
f M
MP
dis
trib
ute
d a
t e
ach
co
nta
ct (
key
info
rma
nt
inte
rvie
ws)
• W
ha
t a
re t
he
ma
in s
tra
teg
ies
for
dis
trib
uti
ng
MM
P t
hro
ug
h H
F th
at
hav
e b
ee
n
use
d i
n o
the
r co
un
trie
s, p
arti
cula
rly
in s
ub
-Sa
har
an
Afr
ica
? W
ha
t h
ave
be
en
th
e
mo
st s
ucc
ess
ful s
tra
teg
ies?
Th
e r
ese
arch
pro
toco
l h
as
be
en
sh
are
d w
ith
th
e t
ech
nic
al w
ork
ing
gro
up
on
mic
ron
utr
ien
ts f
or
fee
db
ack.
Fin
din
gs
fro
m t
he
pilo
t w
ill b
e u
sed
to
info
rm t
he
sca
le u
p
of
HF,
usi
ng
MM
P,
acr
oss
th
e c
ou
ntr
y.
3.3
T
ech
nic
al a
ssis
tan
ce t
o s
tre
ng
the
n H
IV/N
utr
itio
n
ass
ess
me
nt
an
d i
nte
gra
tio
n o
f se
rvic
es
SPR
ING
ha
s d
raft
ed
an
d s
ub
mit
ted
th
e f
oll
ow
ing
refi
ne
d a
nd
str
eam
line
d t
oo
ls f
or
ass
ess
ing
fa
cilit
y-le
vel
nu
trit
ion
se
rvic
es
(NA
CS)
:
•
Gu
ide
fo
r In
terv
iew
ing
Faci
lity
In
-Ch
arg
e
•
Gu
ide
fo
r In
terv
iew
ing
Cli
nic
/Un
it C
hie
fs
•
Gu
ide
fo
r In
terv
iew
ing
He
alt
h C
are
Pro
vid
ers
•
Ob
serv
ati
on
s C
he
cklis
t fo
r V
isit
s w
ith
Ch
ildre
n u
nd
er
Tw
o
6
•
Ob
serv
ati
on
s C
he
cklis
t fo
r V
isit
s w
ith
Pre
gn
an
t W
om
en
•
Ob
serv
ati
on
s C
he
cklis
t fo
r V
isit
s w
ith
PLW
H
Pe
nd
ing
co
nsu
lta
tio
n a
nd
fe
ed
ba
ck f
rom
USA
ID,
SPR
ING
will
wo
rk t
o f
inal
ize
Clie
nt
Exi
t
Inte
rvie
w t
oo
ls,
a C
om
mu
nit
y M
ap
pin
g T
oo
l of
Nu
trit
ion
Su
pp
ort
Se
rvic
es,
as
we
ll a
s
gu
ida
nce
fo
r u
se o
f th
e t
oo
ls.
Ne
xt q
uar
ter,
SP
RIN
G w
ill c
on
tin
ue
to
exp
lore
po
ssib
le a
rea
s fo
r o
pe
rati
on
s re
sea
rch
(OR
) o
r im
ple
me
nta
tio
n r
ese
arch
on
in
no
vati
ve a
pp
roa
che
s to
in
teg
rate
nu
trit
ion
in
to
HIV
se
rvic
es.
On
e p
roto
col l
ike
ly t
o b
e d
eve
lop
ed
is
for
imp
lem
en
tati
on
re
sear
ch o
n
alt
ern
ati
ve a
pp
roa
che
s to
tra
inin
g h
ea
lth
care
pro
vid
ers
on
th
e d
eli
very
of
nu
trit
ion
serv
ice
s (N
AC
S).
3.4
N
utr
itio
n w
ork
forc
e c
ap
aci
ty a
sse
ssm
en
t a
nd
gu
ida
nce
a.
De
sig
n c
urr
icu
lum
, st
ruct
ure
an
d c
on
ten
t fo
r
nu
trit
ion
SB
CC
e-l
ea
rnin
g m
od
ule
Th
e N
utr
itio
n S
BC
C e
-le
arn
ing
lan
dsc
ap
e a
na
lysi
s is
ne
ari
ng
com
ple
tio
n.
Th
is w
ork
is
inte
nd
ed
to
id
en
tify
are
as
for
po
ten
tia
l en
ga
ge
me
nt
tha
t w
ill c
om
ple
me
nt
no
t d
up
lica
te,
exi
stin
g e
-le
arn
ing
co
urs
es.
Th
e l
an
dsc
ap
e a
na
lysi
s w
ill b
e c
om
ple
ted
ea
rly
in t
he
ne
xt
qu
art
er.
b.
Do
cum
en
t ke
y fe
atu
res
of
the
nu
trit
ion
wo
rk
forc
e a
nd
est
ab
lish
co
mp
ete
nci
es
Th
e l
ack
of
inte
llig
en
ce a
t th
e n
ati
on
al l
eve
l on
th
e c
ap
acit
y g
ap
s1 t
o o
pe
rati
on
aliz
e
na
tio
na
l nu
trit
ion
str
ate
gie
s a
nd
imp
lem
en
t h
igh
imp
act
in
terv
en
tio
ns
ha
s b
ee
n a
ma
jor
imp
ed
ime
nt
to t
he
sca
le-u
p in
co
un
trie
s w
ith
a h
igh
-bu
rde
n o
f st
un
tin
g.
A r
ese
arc
h
pro
toco
l w
as
de
velo
pe
d t
ha
t w
ill a
ssis
t in
th
e s
itu
ati
on
al a
nal
ysis
of
the
typ
es
of
wo
rke
rs
resp
on
sib
le f
or
imp
lem
en
tin
g n
ati
on
al n
utr
itio
n a
ctio
n p
lan
s in
va
rio
us
cou
ntr
ies
wit
h a
hig
h-b
urd
en
of
stu
nti
ng
. T
he
stu
dy
will
als
o h
igh
lig
ht
som
e o
f th
e c
ap
acit
y ch
alle
nge
s
tha
t m
ay
hin
de
r th
e s
cale
-up
an
d im
ple
me
nta
tio
n o
f n
utr
itio
n s
pe
cifi
c a
nd
se
nsi
tive
. T
he
rese
arc
h w
ill r
evi
ew
var
iou
s q
ua
lita
tive
me
tho
ds
to a
na
lyze
th
e s
ize
, co
mp
osi
tio
n a
nd
att
rib
ute
s o
f th
e n
utr
itio
n w
ork
forc
e in
co
un
trie
s, a
sse
ss t
he
ir r
ole
s a
nd
re
spo
nsi
bili
tie
s
an
d a
na
lyze
th
e t
ype
of
tra
inin
g th
ese
wo
rke
rs h
ave
re
ceiv
ed
. T
his
re
sear
ch w
ill b
e
imp
lem
en
ted
in t
hre
e c
ou
ntr
ies
in t
he
ne
xt q
ua
rte
r.
3.5
A
na
lysi
s a
nd
do
cum
en
tati
on
co
un
try-
leve
l
eff
ort
s to
re
du
ce u
nd
ern
utr
itio
n o
ver
tim
e
("P
ath
wa
ys t
o B
ett
er
Nu
trit
ion
" C
ase
Stu
die
s)
In c
oo
pe
rati
on
wit
h R
EA
CH
, SP
RIN
G i
s m
ovi
ng
forw
ard
wit
h f
ield
ing
the
ba
seli
ne
inte
rvie
ws
an
d d
ata
co
llect
ion
fo
r th
e U
ga
nd
a ca
se s
tud
y in
Ma
y/Ju
ne
20
13
. T
he
na
tio
nal
leve
l in
terv
iew
to
ols
are
in f
inal
re
vie
w, a
nd
ke
y in
form
an
t lis
ts a
re in
pre
pa
rati
on
.
1 C
ap
aci
ty h
as
be
en
de
fin
ed
in t
he
pu
blic
he
alt
h li
tera
ture
as
the
ab
ilit
y to
car
ry o
ut
the
sta
ted
ob
ject
ive
s. I
n t
he
co
nte
xt o
f h
eal
th w
ork
ers
- c
ap
aci
ty is
de
fin
ed
as
the
ab
ility
of
the
he
alt
h w
ork
er
to p
erf
orm
eff
ect
ive
, eff
icie
nt
and
su
sta
ina
ble
nu
trit
ion
act
ion
s so
as
to a
chie
ve n
utr
itio
n-r
ela
ted
he
alt
h o
utc
om
es.
7
SPR
ING
an
d R
EA
CH
ha
ve e
xch
an
ged
to
ols
an
d b
oth
will
co
nti
nu
e t
o s
har
e f
ind
ing
s a
nd
less
on
s le
arn
ed
to
en
rich
th
e f
ind
ing
s o
f b
oth
eff
ort
s. T
he
re m
ay
be
ro
om
fo
r fo
rmal
coll
ab
ora
tio
n a
s th
e R
EA
CH
eva
lua
tio
n n
ea
rs c
on
clu
sio
n, w
ith
SP
RIN
G p
ote
nti
ally
pla
yin
g
a r
ole
as
thir
d p
art
y e
valu
ato
r. A
fte
r th
e b
ase
lin
e d
ata
ha
s b
ee
n a
nal
yze
d n
ext
qu
art
er,
SPR
ING
will
se
nd
an
an
alys
t to
sit
in
th
e O
ffic
e o
f th
e P
rim
e M
inis
ter
(OP
M)
for
fou
r to
six
mo
nth
s to
co
nti
nu
e m
on
ito
rin
g o
f p
rogr
ess
, a
nd
to
de
velo
p w
ith
th
e O
PM
an
M&
E
syst
em
.
3.6
T
ech
nic
al a
ssis
tan
ce t
o im
pro
ve m
etr
ics
an
d
me
asu
rem
en
t te
chn
iqu
es
for
mo
nit
ori
ng
nu
trit
ion
sca
le-u
p
As
a p
art
of
the
de
velo
pm
en
t o
f th
e t
oo
ls f
or
the
ca
se s
tud
ies,
SP
RIN
G h
as
be
en
dra
win
g
fro
m t
he
late
st r
ese
arc
h t
o d
eve
lop
ne
w w
ays
of
tra
ckin
g ch
an
ge
an
d p
rogr
ess
wit
hin
syst
em
s a
nd
will
be
ab
le t
o b
eg
in t
o t
est
so
me
of
the
se m
eth
od
s a
s m
on
ito
rin
g b
eg
ins.
SPR
ING
ha
s al
so i
de
nti
fie
d S
BC
C p
rogr
am m
on
ito
rin
g a
s a
sign
ific
an
t kn
ow
led
ge
ga
p, a
nd
be
gu
n d
iscu
ssio
ns
inte
rnal
ly t
o m
ove
fo
rwar
d w
ith
de
velo
pin
g a
nd
val
ida
tin
g m
ea
sure
s
via
qu
ali
tati
ve m
ea
ns.
3.7
Im
ple
me
nt
act
ivit
ies
to im
pro
ve r
esi
lien
cy in
th
e
Sah
el-
Bu
rkin
a Fa
so
Pla
nn
ing
for
the
SP
RIN
G/S
ah
el
pro
ject
is w
ell
un
de
rwa
y. D
uri
ng
this
qu
art
er,
SP
RIN
G
revi
sed
se
vera
l dra
fts
of
the
pro
ject
co
nce
pt
no
te a
nd
in
itia
l pla
nn
ing
co
mm
en
ced
.
SPR
ING
me
t w
ith
USA
ID in
Ap
ril
to d
iscu
ss e
xpe
cta
tio
ns
for
the
act
ivit
y in
lig
ht
of
the
rece
nt
RE
GIS
-ER
RFA
. A
t th
is m
ee
tin
g,
SPR
ING
co
mm
itte
d t
o d
raft
ing
an
in
dic
ati
ve w
ork
pla
n/b
ud
get
to f
acili
tate
a d
ialo
gu
e a
nd
re
ach
agr
ee
me
nt
on
ho
w t
he
SP
RIN
G/S
ah
el
pro
ject
act
ivit
ies
will
un
fold
, in
clu
din
g th
e b
ud
ge
t a
lloca
tio
n a
cro
ss t
he
tw
o p
rim
ary
pro
ject
co
mp
on
en
ts (
SBC
C s
tra
teg
y/m
ate
ria
ls d
eve
lop
me
nt,
an
d t
he
lear
nin
g a
ge
nd
a).
4
.1
Exp
an
d g
lob
al l
ear
nin
g o
n a
gri
cult
ure
an
d
nu
trit
ion
th
rou
gh
imp
lem
en
tati
on
of
the
Ag
N-
GLE
E a
nd
fo
llo
w u
p t
ech
nic
al a
ssis
tan
ce
In M
arc
h 2
01
3,
SPR
ING
co
mp
lete
d t
he
fin
al t
wo
Ag
N-G
LEE
wo
rksh
op
s in
Gu
ate
mal
a C
ity
an
d B
an
gko
k. I
n t
ota
l, t
he
th
ree
wo
rksh
op
s d
rew
26
2 p
art
icip
an
ts c
on
sist
ing
of
mis
sio
n
sta
ff,
imp
lem
en
tin
g p
artn
ers
, U
SAID
/DC
an
d lo
cal m
inis
try
off
icia
ls f
rom
17
Fe
ed
th
e
Futu
re a
nd
ad
dit
ion
al o
bse
rve
r co
un
trie
s. O
vera
ll, t
he
Ag
N-G
LEE
s w
ere
su
cce
ssfu
l in
fost
eri
ng
dis
cuss
ion
an
d e
ng
age
me
nt
aro
un
d b
est
pra
ctic
es
to s
tre
ng
the
n a
nd
alig
n F
TF
inve
stm
en
ts t
o b
ett
er
ach
ieve
nu
trit
ion
ou
tco
me
s. T
he
y a
lso
ge
ne
rate
d m
an
y q
ue
stio
ns
tha
t SP
RIN
G w
ill a
nsw
er
thro
ug
h t
he
fo
llo
w-o
n in
itia
tive
s w
ith
BFS
. N
ext
qu
arte
r, S
PR
ING
will
co
mp
lete
th
e f
ina
l wo
rksh
op
an
d la
nd
sca
pe
an
alys
is r
ep
ort
an
d b
eg
in w
ork
pla
nn
ing
for
the
BFS
en
ga
gem
en
t.
4.2
D
eve
lop
an
d t
est
str
ate
gie
s to
str
eam
line
th
e
inte
gra
tio
n o
f n
utr
itio
n a
nd
hyg
ien
e
inte
rve
nti
on
s w
ith
in a
gric
ult
ure
pro
ject
s
Th
e f
ield
co
mp
on
en
t o
f th
e q
ual
ita
tive
re
sea
rch
on
agr
icu
ltu
re a
nd
nu
trit
ion
in
Ba
ng
lad
esh
wa
s co
mp
lete
d t
his
re
po
rtin
g p
eri
od
, d
esp
ite
de
lays
du
e t
o p
olit
ica
l un
rest
.
A f
ull
rep
ort
will
be
ava
ilab
le in
Q3
.
8
4.3
T
ech
nic
al a
ssis
tan
ce t
o s
tre
ng
the
n u
se o
f H
CE
S
to d
esi
gn
, e
stim
ate
imp
act,
an
d m
on
ito
r
nu
trit
ion
pro
gram
s
Nig
eri
a’s
20
10
Liv
ing
Co
nd
itio
ns
Mo
nit
ori
ng
Su
rve
y h
as
be
en
tra
nsf
orm
ed
in
to a
nu
trie
nt
an
aly
tic
file
. Fo
r N
ige
ria
an
d B
an
gla
de
sh h
ou
seh
old
an
d i
nd
ivid
ua
l ho
use
ho
ld m
em
be
rs’
est
ima
ted
ca
lori
c, ir
on
, vi
tam
in A
, zin
c a
nd
ca
lciu
m a
pp
are
nt
inta
ke le
vels
an
d i
nta
ke
ina
de
qu
acie
s h
ave
be
en
est
ima
ted
na
tio
nal
ly a
nd
su
b-n
ati
on
all
y b
y se
vera
l so
cio
-
eco
no
mic
bre
akd
ow
ns.
Th
e m
ost
co
mm
on
fo
od
so
urc
es
of
calo
rie
s, ir
on
, vi
tam
in A
, zin
c
an
d c
alci
um
ha
ve b
ee
n id
en
tifi
ed
. SP
RIN
G h
as
pro
vid
ed
EC
SA a
dvi
ce f
or
the
age
nd
a o
f it
s
pla
nn
ed
HC
ES
an
d F
ort
ific
ati
on
Wo
rksh
op
pla
nn
ed
fo
r Ju
ly in
Lu
saka
.
4.4
R
ese
arc
h s
tud
y o
n i
nte
gra
tio
n
In c
on
sult
ati
on
wit
h p
art
ne
rs H
KI
an
d I
FPR
I, S
PR
ING
is d
eve
lop
ing
pla
ns
to im
ple
me
nt
the
ag
ricu
ltu
re a
nd
nu
trit
ion
wo
rk in
Bu
rkin
a Fa
so,
bu
ildin
g u
po
n b
oth
exi
stin
g H
KI/
IFP
RI
ag
-
nu
trit
ion
pro
ject
s a
nd
on
re
cen
tly
ob
tain
ed
fu
nd
ing
fro
m C
IDA
fo
r th
ose
pro
ject
s
con
tin
ua
tio
n.
Re
sea
rch
qu
est
ion
s ar
e u
nd
er
de
velo
pm
en
t fo
r th
at
en
ga
ge
me
nt.
5.1
T
ech
nic
al a
ssis
tan
ce t
o t
he
Sca
lin
g U
p N
utr
itio
n
(SU
N)
Glo
ba
l Mo
vem
en
t to
incr
ea
se
eff
ect
ive
ne
ss o
f n
ati
on
al n
utr
itio
n p
rog
ram
s
SPR
ING
co
nti
nu
ed
co
nve
rsa
tio
ns
wit
h R
EA
CH
an
d w
ill c
oll
ab
ora
te o
n t
he
Ug
an
da
pro
spe
ctiv
e c
ase
stu
die
s. S
eve
ral
hig
h-l
eve
l me
eti
ng
s al
so o
ccu
rre
d t
his
qu
art
er.
In
Feb
rua
ry, S
PR
ING
me
t w
ith
Pa
triz
ia F
raca
ssi o
f th
e S
UN
Se
cre
tari
at
to d
iscu
ss p
oss
ible
op
po
rtu
nit
ies
for
futu
re e
ng
ag
em
en
t. I
n M
arc
h,
SPR
ING
me
t w
ith
th
e D
avid
McN
air
,
Ad
viso
r to
th
e C
ha
ir o
f th
e S
UN
CSO
to
exp
lore
op
po
rtu
nit
ies
for
sup
po
rtin
g th
e C
SO
Ne
two
rk.
As
the
sco
pe
of
wo
rk e
volv
es,
SP
RIN
G c
on
tin
ue
s to
re
vise
th
e S
PR
ING
/SU
N
con
cep
t n
ote
.
5.2
Le
ad
ers
hip
an
d/o
r p
arti
cip
ati
on
in n
etw
ork
s to
ide
nti
fy p
rod
uct
s, d
ocu
me
nts
, sh
are
d l
ear
nin
g,
an
d a
dvo
cacy
op
po
rtu
nit
ies
As
pa
rt o
f a
wo
rkin
g g
rou
p o
rga
niz
ed
by
the
Ne
w Y
ork
Aca
de
my
of
Scie
nce
(N
YA
S),
SPR
ING
dra
fte
d s
ect
ion
s o
n u
pst
ream
(m
an
age
me
nt
cap
aci
tie
s, t
rain
ing
pro
cess
es,
mo
tiva
tio
ns,
as
we
ll a
s ca
pac
itie
s fo
r p
rod
uct
ion
of
foo
ds/
MN
s) a
nd
mid
stre
am
pro
cess
es
(su
pe
rvis
ion
& m
an
age
me
nt
pro
cess
es,
an
d s
up
ply
ch
ain
fo
r fo
od
s/M
NS)
in
nu
trit
ion
de
live
ry s
cie
nce
. T
he
se s
ect
ion
s w
ill f
orm
par
t o
f an
ove
rall
wh
ite
pa
pe
r o
n
pro
gra
m t
he
ory
an
d im
pa
ct p
ath
wa
ys t
o s
up
po
rt e
ffe
ctiv
e d
eli
very
of
nu
trit
ion
inte
rve
nti
on
s th
at
will
be
pu
bli
she
d b
y th
e N
YA
S A
nn
als
an
d r
efe
ren
ced
in
th
e L
an
cet.
SPR
ING
is
the
co
-org
an
ize
r o
f T
rack
3 f
or
the
up
com
ing
Mic
ron
utr
ien
t Fo
rum
in J
un
e
20
14
in
Eth
iop
ia.
Du
rin
g th
e r
ep
ort
ing
pe
rio
d,
SPR
ING
ha
s p
art
icip
ate
d in
dis
cuss
ion
s o
n
the
dra
ft s
che
du
les
of
Tra
ck 3
pa
ne
ls a
nd
pre
sen
tati
on
as
we
ll a
s th
e in
clu
sio
n o
f
sele
cte
d S
PR
ING
mic
ron
utr
ien
t-fo
cuse
d a
ctiv
itie
s.
5.3
T
ech
nic
al a
ssis
tan
ce t
o P
ea
ce C
orp
s b
y p
iloti
ng
the
ir F
ITU
(Fo
cus
In &
Tra
inin
g U
p)
ap
pro
ach
in
nu
trit
ion
A T
rain
ing
of
Tra
ine
rs f
or
five
Pe
ace
Co
rps/
We
st A
fric
a F
oo
d S
ecu
rity
Par
tne
rsh
ip
cou
ntr
ies
(Be
nin
, Gu
ine
a,
Sen
eg
al,
Gam
bia
, Si
err
a Le
on
e)
was
co
mp
lete
d w
ith
40
pa
rtic
ipa
nts
tra
ine
d.
Act
ion
pla
ns
to r
oll-
ou
t E
NA
-EH
A w
ere
de
velo
pe
d.
An
In
-Se
rvic
e
Tra
inin
g o
n E
NA
-EH
A w
as
als
o c
on
du
cte
d i
n B
en
in w
ith
44
pa
rtic
ipa
nts
tra
ine
d.
6.1
T
ech
nic
al a
ssis
tan
ce a
nd
gu
idan
ce t
o s
tre
ngt
he
n
com
ple
me
nta
ry f
ee
din
g p
rog
ram
s in
se
lect
ed
SPR
ING
co
un
trie
s
SPR
ING
is
pre
par
ing
te
rms
of
refe
ren
ce f
or
the
de
velo
pm
en
t o
f a
co
mp
reh
en
sive
com
ple
me
nta
ry f
ee
din
g st
rate
gy.
We
exp
ect
to
init
iate
th
is p
roce
ss in
Qu
art
er
3.
9
6.2
A
na
lysi
s a
nd
mo
de
l on
th
e r
ela
tio
nsh
ip o
f e
arl
y
life
un
de
rnu
trit
ion
an
d u
nd
ern
utr
itio
n
pro
gra
mm
ing
on
ris
k o
f la
ter
life
no
n-
com
mu
nic
ab
le d
ise
ase
(N
CD
)
SPR
ING
is
curr
en
tly
com
ple
tin
g th
e f
irst
ph
ase
of
the
mo
de
l, w
ith
fin
al r
esu
lts
exp
ect
ed
by
Ma
y 1
4th
, a
nd
a d
raft
re
po
rt a
vaila
ble
no
lat
er
tha
n M
ay
24
th.
Th
is q
ua
rte
r SP
RIN
G
pre
sen
ted
pre
limin
ary
re
sult
s to
USA
ID a
nd
Bo
b B
lack
at
the
en
d o
f M
arc
h,
an
d h
as
use
d
the
mo
nth
po
st-p
rese
nta
tio
n t
o i
nco
rpo
rate
ch
an
ge
s m
ad
e b
y o
ur
exp
ert
mo
de
l
con
sult
an
ts f
rom
th
e L
on
do
n S
cho
ol
of
Hyg
ien
e a
nd
Tro
pic
al M
ed
icin
e,
ad
just
th
e f
ina
l
pre
sen
tati
on
of
resu
lts
to r
efl
ect
co
mm
en
ts p
rovi
de
d b
y U
SAID
an
d D
r. B
lack
, an
d t
o
de
velo
p a
re
po
rt o
f th
e m
eth
od
s, a
nn
ota
ted
bib
liogr
ap
hy,
an
d f
ind
ing
s.
6.3
D
efi
nit
ion
of
the
ore
tica
l im
pac
t p
ath
wa
ys o
f
ma
tern
al a
nd
ch
ild
car
e p
ract
ice
s
Th
is a
ctiv
ity
wil
l bu
ild
up
on
th
e S
BC
C li
tera
ture
re
vie
w i
s fi
nal
ize
d a
nd
will
vis
ua
lly
pre
sen
tin
g th
e f
ind
ing
s a
lon
g w
ith
on
-go
ing
rese
arc
h o
n S
PR
ING
-pro
mo
ted
, evi
de
nce
-
ba
sed
, h
igh
-im
pa
ct n
utr
itio
n p
ract
ice
s. S
imila
rly,
th
e d
eve
lop
me
nt
of
me
tric
s fo
r
mo
nit
ori
ng
an
d e
valu
ati
ng
SBC
C a
pp
roa
che
s a
nd
ou
tco
me
s sh
ou
ld f
oll
ow
th
e c
om
ple
tio
n
of
the
SB
CC
lite
ratu
re r
evi
ew
an
d w
ill b
uil
d o
n c
ou
ntr
y-le
vel M
&E
act
ivit
ies,
as
we
ll a
s th
e
refi
ne
d,
sta
nd
ard
ize
d,
and
str
ea
mli
ne
d t
oo
ls f
or
ass
ess
ing
fac
ility
-le
vel
nu
trit
ion
se
rvic
es
(NA
CS)
.
6.4
Im
ple
me
nta
tio
n o
f K
no
wle
dge
Ma
na
ge
me
nt
(KM
) p
latf
orm
acr
oss
va
rio
us
me
dia
to
sh
are
an
d
dis
sem
ina
te in
form
ati
on
See
se
ctio
n I
V o
n K
M b
elo
w.
6.5
P
rovi
de
KM
su
pp
ort
fo
r co
re a
nd
co
un
try-
rela
ted
ob
ject
ive
s
See
se
ctio
n I
V o
n K
M b
elo
w.
10
III. Country Updates
Bangladesh Field Support Program Implementation Activities conducted this quarter:
SPRING focused on the following:
• Scaling-up training on nutrition, hygiene and homestead food production;
• Monitoring the quality of nutrition activities of trained officers;
• Establishing home gardens among households with pregnant women and children under the age
of two;
• Advocating for increased stakeholder involvement in mainstreaming nutrition and hygiene
across multiple sectors.
Scaling-up of nutrition and hygiene training within Ministry of Health and Family Welfare (MOHFW)
and Ministry of Agriculture (MOA)
SPRING/Bangladesh trained 2,575 supervisory and frontline health and agriculture workers on essential
nutrition and hygiene actions (ENHA). This completes ENHA training for all frontline sub-assistant
agriculture officers (SAAOs) in all 40 upazilas. SPRING/Bangladesh is on track to complete all ENHA
trainings for all Government of Bangladesh (GOB) supervisory and frontline health workers by the end of
May 2013.
Monitoring the quality of nutrition activities of trained officers
In addition to the trainings conducted, SPRING/Bangladesh dedicated significant resources to appraising
the quality of nutrition services delivered after the training by monitoring and providing supportive
supervision to trainees. Each of the trainees received monthly monitoring visits and quarterly supportive
supervision visits. Data from monitoring and supportive supervision tools used shows that, on average,
73% (82% in Barisal and 64% in Khulna) of trained GOB health workers appropriately counsel pregnant
or lactating mothers on at least four key stage-appropriate nutrition and hygiene messages.
The cumulative total of 4,899 (FY12 and FY13) for number of GOB health and agriculture staff and
technical and community mobilization project staff trained represents 148% of the cumulative target of
3310. This represents a significant achievement in the project’s progress towards its target goals.
Establishing home gardens among households with pregnant women and children under two
Nine thousand nine hundred and thirty-six (9936) households with pregnant women and children under
two were recruited into farmer field schools (FFS) during the reporting period. FFS participants received
training on topics ranging from land preparation and composting to exclusive breastfeeding for children
under six months, complementary feeding for children between 6 - 24 months and women's nutrition.
Through local implementing partner non-governmental organizations (IPNGOs), SPRING/Bangladesh
currently supports 1,301 FFS with bi-monthly meetings and a total cumulative enrollment of 29,217
participants. Seeds were distributed to all 29,217 FFS participants. Each household received six varieties
of nutrient-dense summer vegetables for the cultivation of home gardens. There are currently over
24,800 SPRING-supported home gardens (defined as seeds in the ground) across 40 upazilas in Barisal
and Khulna divisions. SPRING/Bangladesh recognizes the importance of animal-source foods as a protein
source for diets of pregnant women and children between 6 - 24 months. To facilitate protein
consumption, FFS participants were trained on poultry rearing. SPRING/Bangladesh began supporting
11
households in rearing poultry by contributing poultry sheds to households committed to purchasing and
maintaining poultry for their household use.
Advocating for increased stakeholder involvement in mainstreaming nutrition and hygiene across
multiple sectors
SPRING/Bangladesh hosted a seminar on "implementing nutrition across multiple channels" in Dhaka to
highlight the project’s approach in mainstreaming nutrition and hygiene across agriculture and health
partners. The seminar was attended by over 90 technical and strategic leads from nutrition, agriculture
and health projects as well as health and agriculture workers within the Government of Bangladesh and
households participating in SPRING's home gardening interventions.
Additionally, the project participated and jointly presented with Shannon Young, of USAID/Bangladesh’s
health office, at the AgN-GLEE workshop in Bangkok, Thailand in March. SPRING/Bangladesh was
featured as a case study for strategies and implementation approach of integrating nutrition, hygiene
and agriculture.
Meetings and trainings attended this quarter
The project attends monthly Directorate General of Family Planning (DGFP), Directorate General of
Health Services (DGHS) and Department of Agricultural Extension (DAE) upazila health and family
planning coordination meetings in all 40 intervention upazilas and remains an active participant in
Dhaka with the national nutrition working group, SUN, Revitalization of Community Health Care
Initiative in Bangladesh NGO coordination meetings.
Dr. Nargis of RCHCIB in blue sari seated among SPRING FFS participants in Phultala,
Khulna
12
Networking, qualitative research and temporary duty (TDY) visits
SPRING/Bangladesh hosted Dr. Makhduma Nargis, Project Director, Revitalization of Community Health
Care Initiative in Bangladesh (RCHCIB), Dr. Baren Mandal (RCHCIB), Dr. Mustafiz Rahman of the Institute
of Public Health and Nutrition (IPHN) and the National Nutrition Services (NNS), Dr. Nasreen Khan
(IPHN/NNS), and Ms. Shannon Young (USAID) at a day-long site visit in Phultala, Khulna. The visit
afforded the GOB officials an opportunity to assess SPRING activities through GOB health facilities and at
the community level. The visit yielded meaningful discussions, including an extension of the
memorandum of understanding between SPRING, NNS and RCHCIB.
The project supported two SPRING core qualitative research activities during the reporting period. The
research topics were on "factors motivating homestead gardening household decisions for crops to
plant, selling vs. consuming produce, and purchasing nutritious foods" and "factors motivating men’s
food purchase choices." This research contributed to the efforts to further explore the nexus of
agriculture and nutrition and will also serve to inform SPRING/Bangladesh. The results from this
research are expected in the second half of FY13 and will be used to improve ongoing activities and
enhance messages to better meet the needs and contexts of the target populations to ultimately
improve nutrition outcomes.
Internal project review and gender training The project conducted an annual and program review meeting. The meeting was with all
SPRING/Bangladesh staff members and was held over two days in Khulna. It afforded the team an
opportunity to network across divisions, reflect on past activities from the last fiscal year, and explore
SPRING’s challenges/accomplishments and design future direction.
SPRING conducted five rounds of gender training for SPRING and local implementing partner staff
members over this reporting period.
Other important updates
Bangladesh has continued to experience cases of sporadic violence and disruption of normal activities
due to political and religious unrest. These activities are often manifested as demonstrations or hartal
days. So far, the effects of hartals on project implementation have been minimal. However, due to its
increasing frequency, SPRING/Bangladesh has started collecting hartal reports for any week in which a
hartal was called to monitor its effects within the project.
Major activities to be completed in the next quarter (Q3):
- Complete support for planting home gardens with FFS participants
- Begin training for community and support group members of Community Clinics
- Begin refresher training for trained health and agriculture workers from FY12
- Complete gender trainings for SPRING and IPNGO staff
- Update GPS data collection
- Launch online data collection system
- Complete revisions for final printing of all SPRING/Bangladesh training materials
- Conclude strategic planning for FY14 and beyond, including revising targets, defining appropriate
coverage and renewing/forging strategic partnerships
13
Haiti Field Support Program Implementation Activities Conducted this Quarter
During this quarter, SPRING/Haiti conducted a number of important activities to initiate the process of
strengthening NACS services in the six health facilities prioritized for FY13. These activities are described
in greater detail below. It is important to note that Departmental Nutrition Focal Points participated in
all SPRING activities at the health facilities in an effort to ensure Ministère de la Santé Publique et de la
Population (MSPP) support and sustainability of SPRING work. The Nutrition Focal Points are the liaison
between MSPP Central Bureau in Port-au-Prince and each of the ten Departments in Haiti. Each Focal
Point has two or three assistants, and is in charge of all nutrition activities within their Department from
nutrition surveillance, TOTs, to vaccination campaigns. They supervise health institutions whether public
or private. The Focal Points sit at the Departmental Directorates of Health.
Development of IYCF training package
SPRING/Haiti, with the technical assistance from consultant Ms. Marjolein Moreaux, worked closely with
the MSPP to develop a facility-based training package on IYCF. The need for the package was identified
during the NACS assessment conducted in FY12, and content for the package was developed based on a
quick assessment conducted in two health facilities to understand specific needs to be addressed in the
curriculum. The content drew on the existing IYCN training materials, the UNICEF/IYCF guide, the WHO
integrated course, the FANTA protocol and guidance from the MSPP Nutrition Directorate team. The
training package is designed in a modular approach for on-the-job training, which was welcomed by the
MSPP and health facilities as it reduces the amount of time health workers schedules are disrupted for
trainings.
Hôpital Alma Mater by Nicole Racine (March 12, 2013)
14
Assessment of nutrition needs
Two of the six targeted health facilities participated in the NACS assessment conducted in FY12. To
better understand the readiness of the remaining four health facilities to implement NACS, the
SPRING/Haiti team conducted a series of visits to these facilities. Using a revised set of assessment tools,
a comprehensive NACS assessment was conducted in Hôpital Maternité de Carrefour. Pre-assessment
meetings were conducted in Hôpital Universitaire La Paix, Hôpital Alma Mater de Gros-Morne and
Hôpital Sacré-Cœur de Milot. The assessment and pre-assessment meetings showed that these four
health facilities have similar challenges as those found in Hôpital Universitaire Justinien and Hôpital St-
Nicolas during the NACS assessment in FY12.
These common findings included:
- The need for training in NACS;
- A lack of materials for how to conduct nutrition counseling;
- A gap in human resources (which SPRING cannot affect);
- High patient volume;
- Resistance to change as health providers do not want to take on “additional” tasks;
- The need for better coordination between Nutritional Directorates and health facilities;
- A lack of nutrition supplies and equipment, such as scales for infants, children and adults, and
height/length boards, and MUAC tapes;
- Concern regarding the close-out of the Manman ak Timoun Ansante project this year, as many
health personnel were hired under this project;
- The need for training in anthropometric measurement.
In order to establish a reliable baseline, in April and May 2013 the comprehensive NACS assessment
using revised tools will be carried out in Hôpital de Alma Mater de Gros-Morne, Hôpital Sacré-Cœur de
Milot and Hôpital Universitaire La Paix.
Training on anthropometric measurement and reporting
In February and March 2013, SPRING/Haiti arranged for key staff in all six health facilities to participate
in MEASURE Evaluation’s training on anthropometric measurement, proper data collection and data
entry. Nine health workers participated (two from Carrefour, one from La Paix, two from Hôpital St-
Nicolas, two from Hôpital de Alma Mater de Gros-Morne, two from Hôpital Universitaire Justinien, and
one from Hôpital Sacré-Cœur de Milot). Next quarter during monthly supervision visits, SPRING/Haiti will
follow-up on correct utilization of equipment, data collection on nutritional surveillance and correct
documentation of data.
Anthropometric equipment and nutrition supplies
This quarter, SPRING/Haiti facilitated communication and coordination between UNICEF, WFP, health
facilities and the departmental directorates to ensure the continued availability of anthropometric
equipment and nutrition supplies, which are essential for the delivery of NACS services.
SPRING/Haiti participated in several meetings with UNICEF, the Nutrition Directorates in the West,
North, Artibonite, and the health facilities to facilitate the delivery of equipment to the facilities,
including infant scales, height/length boards for young children, and scales for children and adults.
Because of limited availability at the departmental level, only one third of the requested equipment was
remitted to the health facilities during the reporting period.
15
With regard to nutrition supplies such as RUTF and food rations, it has been difficult for SPRING/Haiti to
clearly understand the reasons why health facilities have stock outs, especially since UNICEF and WFP
reported no problems with their supply chain this year. UNICEF attributes the stock outs at the health
facility-level to untimely requests from Departmental Directorates and distribution to clients at the
health facilities not following MSPP norms.
In speaking with the health facilities themselves, SPRING/Haiti detected a problem with the flow of the
supplies beginning with the stock room, the units and the distribution to clients. In one such
conversation, one health facility explained that they requested RUTF from UNICEF, but did not receive
any. In a follow up conversation with UNICEF, UNICEF explained that they would supply the RUTF, but
that the facility needed to send a usage report first because UNICEF had supplied above what the facility
had requested for the previous month.
Next quarter, SPRING/Haiti will continue to work as liaison for both the Departmental Directorates and
UNICEF, and facilitate the delivery of all anthropometric equipment needed in the health facilities. In
addition, SPRING/Haiti will conduct observations of the logistics systems for nutrition supplies beginning
with the reception of supplies from UNICEF, WFP or the Departmental Directorates by the stock keeper,
the requests submitted by the different units and the distribution to clients to try and identify if and
where the problems exist.
To serve as a reference for health workers and until additional hard copies can be provided by MSPP,
SPRING/Haiti has provided an electronic version of the national norms document to all six health
facilities.
Orienting health facility staff on the NACS approach
Jointly with FANTA, SPRING/Haiti prepared a Power Point presentation on NACS to use as a two-hour
information/training session with facility staff. SPRING/Haiti conducted the training with 22 health
workers and nutrition staff at Hôpital Universitaire Justinien and 2 Nutrition Focal Points from the North
Departmental Directorate on March 13 and with 13 health workers and nutrition staff at Hôpital St-
Nicolas on March 26. Next quarter, training sessions will also be held at Hôpital Universitaire La Paix,
Hôpital St-Nicolas, Hôpital Alma Mater de Gros-Morne and Hôpital Sacré-Cœur de Milot. SPRING/Haiti
received positive feedback on the training from participants. Participants noted their interest in using
the Power Point presentation for other health workers to reinforce NACS and apply the national norms.
SPRING/Haiti will submit the presentation to the MSPP and USAID for feedback before it is shared more
widely.
Building on the orientation visits, the SPRING/Haiti team developed an approach for conducting
systematic, regular health facility visits called ‘Reinforcement Visits (RVs).’ The main objectives of RVs
are to support the roll-out and implementation of NACS services to all units of the health facilities and
improve the quality of NACS services provided through health facilities. SPRING/Haiti developed
guidance for how each RVs should be conducted. To support the roll-out and implementation and
quality of NACS services in health facilities, SPRING/Haiti will be conducting RVs during the course of the
project. This quarter, RVs were initiated in Cap Haïtien on March 13, Carrefour on March 19 and 20 and
Cap Haïtien on March 25 to:
- Facilitate the supply of RUTF, dry rations, scales, height boards and MUAC tapes to the health
facility;
- Improve nutrition assessment services, including how to properly measure the height and
weight of adults and children;
- Observe whether data are collected and registered correctly;
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- Improve IYCF counseling skills;
- Train health facility staff on NACS [note: a total of 48 health workers were trained this quarter
(see attached in annex)]; and,
- Provide health facilities with counseling checklists, IYCF counseling cards, infant nutrition norms
documents, weight-height z-score tables, and body mass index tables.
SPRING/Haiti also participated in the MSPP/FANTA-led two-day orientation workshop on the NACS
approach. This workshop was held for the Nutrition Directorate’s staff and the focal points from the 10
Departmental Directorates. SPRING and FANTA also invited two key nutrition staff from each of the
project’s six focus health facilities.
Counseling tools from FANTA
This quarter, SPRING received 60 sets of FANTA counseling cards ‘’Bonjan abitid nan manje ak lijyen’’ to
be distributed to the six targeted health facilities during reinforcement visits. The FANTA counseling
cards were developed in 2010, in collaboration with the MSPP, for health providers and community
counselors to strengthen the provision of nutrition counseling to PLHIV. Nutrition Focal Points in the
North and the Artibonite have already been trained by FANTA on NACS and how to use the FANTA
counseling tool.
Meetings and trainings attended this quarter
SPRING attended and participated in the following meetings and trainings this quarter:
- MSPP nutrition technical committee meetings in January and February 2013;
- MSPP/FANTA two-day workshop on February 28 and March 1;
- HEALTHQUAL four-day workshop on February 5-8;
- Meeting with UNICEF to discuss anthropometric material; and
- Meeting with Departmental Directorate/West to particularly discuss the anthropometric
material for Hôpital Maternité de Carrefour.
Activities planned for next quarter (Q3)
- Continue to facilitate supply of nutrition supplies and equipment to health facilities;
- Conduct observations of the supply chain within the health facilities, including distribution to
clients based on national norms in order to determine what causes the stock-outs;
- Complete NACS assessment in Hôpital Sacré-Cœur de Milot, Hôpital Alma Mater de Gros-Morne
and Hôpital Universitaire La Paix, including data analysis and presentation of findings to the
health facilities;
- Conduct reinforcement visits to support the roll-out and implementation of NACS in health
facilities;
- Conduct a community mapping exercise;
- Conduct three TOT in IYCF counseling: one in April 2013 for MSPP Nutrition Directorate staff,
one in May for the nutrition focal staff, and one in May for health facility staff; and
- Work closely with Hôpital St-Nicolas’ new Hospital Director (when in place) to introduce the
SPRING project and introduce the NACS approach.
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Nigeria Field Support Program Implementation Activities Conducted this Quarter
SPRING/Nigeria’s main focus for the second quarter of FY 13 has been to support the finalization of the
National Community and Facility Infant and Young Child Feeding (IYCF) training packages, which
includes:
• The Community IYCF (C-IYCF) Facilitator guide, participant manual, counseling cards and key
message booklet
• The Facility IYCF (F-IYCF) trainer’s manual, participant’s manual, counseling cards and key
message booklet
• Training aids and three take-home brochures
Currently, the counseling cards, key message booklet, and three take-home brochures are being
translated into three indigenous languages (Yoruba, Igbo, and Pidgin). Three additional indigenous
languages (Hausa, Tiv, and Idoma) have been field-tested for accuracy and finalized. Final layout of Tiv,
Hausa, and Idoma are currently on-going.
The second quarter of FY13 provided an opportunity for the SPRING/Nigeria team to streamline their
implementation activities by identifying key Local Government Areas (LGAs) within the SPRING focal
states of Benue and Federal Capital Territory (FCT) where SPRING will work. The focal LGAs that SPRING
will focus on are Vandeikya, Ukum, Gboko, Obi, Ohimini and Guma for Benue state, while Abaji, Kuje and
Bwari area councils will be the focus areas in FCT. The selection of the focal LGAs led to intensified
program planning meetings with the state and LGA program officers, including the nutrition focal
persons that identified IYCF programming gaps within those LGAs. These meetings led to the
identification of training needs in the two states. A training plan was developed and split in three
discrete phases for a more strategic implementation plan.
A six-day C-IYCF training was conducted in Ukum and Vandeikya LGAs in Benue state. These trainings
afforded the SPRING/Nigeria team the opportunity to pilot test the finalized C-IYCF package and train
participants on the use of basic C-IYCF monitoring tools. There were 24 community volunteer and health
workers trained from the two Benue LGAs. Additionally, the SPRING/Nigeria team conducted a C-IYCF
baseline assessment in the two selected LGAs. This baseline assessment captured health workers’ and
community members’ knowledge and practice on IYCF in Ukum and Vandeikya.
Training in Benue state Support group formation in Benue state
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In addition, a one-day C-IYCF refresher and monitoring training was conducted in two area councils
within FCT. The purpose of the training was to gather feedback regarding support group activities from
already established support groups in the area councils and to train participants on C-IYCF data
capturing tools. A total of 49 community volunteers and health workers attended the two trainings in
Kuje and Abaji area councils of FCT.
Meetings and trainings attended this quarter
The SPRING/Nigeria team initiated and participated in various meetings at both national and state
levels. The SPRING/Nigeria team presented at the nutrition partners meeting, where various nutrition
partners focused efforts on partnership and program synergy. As part of the sustainability of the
SPRING/Nigeria program in-country, various meetings were held with the Federal Ministry of Health
(FMOH) where presentations of SPRING activities, C-IYCF and F-IYCF monitoring tools and the FMOH
annual work plan were shared for collaboration. Additionally, SPRING/Nigeria participated in a USAID-
organized Orphan and Vulnerable Children (OVC) implementation guidelines finalization meeting held in
Lafia, in Nasarawa state. The meeting provided a forum for SPRING activities to be highlighted to other
USAID OVC implementing partners.
Lastly, SPRING/Nigeria provided technical support and assistance to the C-IYCF training of community
volunteers and health workers organized by the DFID-funded WINNN project in Katsina state.
This quarter SPRING/ Nigeria also welcomed the recruitment of two additional staff: a nutrition officer
and a monitoring and evaluation (M&E) specialist.
Activities Planned for Next Quarter (Q3):
• Launch and disseminate the IYCF packages
• Participate in the national Scaling-up Nutrition (SUN) Launch (tentative dates May 2, 2013)
• Possible addition of Nigerian states to scale-up SPRING activities
• Organize a SPRING quarterly nutrition meeting
• Support World Breastfeeding Week implementation
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Uganda Field Support Program Implementation
Activities Conducted this Quarter The main activities and achievements this quarter were in line with the SPRING/Uganda approved work
plan, May 1, 2012 to September 30, 2013, and are described in more detail below according to category
and intermediate result (IR).
1. Administration and management
SPRING/Uganda continued the process of hiring staff to support program operations and
implementation. During the second quarter, eleven staff members joined the team, including the
Fortification Advisor, Monitoring & Evaluation Analyst, Finance Officer, Administrative Assistant, Office
Assistant, three SBCC Specialists, and three Nutrition Specialists. In addition, a number of consultants
were hired to support short-term activities.
2. Programmatic technical management component
The main activities performed this quarter included:
• Dissemination of results from the SPRING-led assessment of NACS services in health facilities in
SW Uganda
• Provision of technical support to the MOH in developing and pre-testing a NACS training
package for facility-based health providers
• Participation in district nutrition planning meetings; developing a TOR for the National Working
Group on Food Fortification (NWGFF)
• Development of workplans for activities related to the Partnership for HIV-Free Survival (PHFS);
• Implementation of NACS activities in selected health facilities in the SW; and developing a
research protocol for the pilot of home fortification in Uganda.
Other activities that were done included drafting a SPRING/Uganda program impact pathway (PIP),
performance monitoring plan (PMP) and detailed implementation plan (DIP). Each of these activities is
described in more detail below.
Key findings from the assessment of NACS services were disseminated at both the district (Kabale and
Kisoro) and national levels. In Kisoro, dissemination of the findings was done during the district nutrition
planning held on February 1, 2013. Attendees included 60 representatives from the district, health
facilities, and NGOs/CBOs operating in the district. This dissemination resulted in district nutrition action
plans at the district, hospital, health center (HC) and NGO/CBO levels. The Chief Administrative Officer
(CAO), Local Council 5 (LCV) chairman and District Health Officer (DHO) pledged to work together with
SPRING to address malnutrition in the district. In Kabale, dissemination of the findings was conducted on
February 22, 2013 and was attended by more than 40 participants, including representatives from
NGOs/CBOs and CAOs, DHOs and district nutrition coordination committee (DNCC) focal persons from
Kabale, Mbarara, Ibanda, Bushenyi, Sheema, Rukungiri and Kanungu districts. The dissemination also
turned out to be an important nutrition advocacy forum. Representatives from the Uganda Nutrition
Action Plan (UNAP) Secretariat in the Office of the Prime Minister (OPM) presented a strong case on the
need for active involvement of the districts in planning and budgeting for nutrition. An atmosphere of
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hope in seeing budgeted nutrition plans in the development of district plans was created by these
important decision-makers at the end of the dissemination exercise. Finally, at the national level,
SPRING/Uganda disseminated findings during a SPRING-led stakeholders’ workshop on February 13,
2013 in Kampala. In addition to presenting and discussing the findings of the assessment, the objectives
of the workshop included presenting SPRING/Uganda’s approach for addressing malnutrition in the SW
and engaging stakeholders in developing SPRING/Uganda’s PIP, PMP, and DIP. The meeting was
attended by 69 participants from the government, NGOs, USAID, the United Nations and other research
organizations. The government pledged to work closely with SPRING/Uganda to reduce the burden of
malnutrition in SW Uganda, and applauded the participatory approach the program has taken to engage
all key partners in the planning and implementation of the interventions at national and district levels.
Representatives from the Ministry of Health and Office of the Prime Minister applauded SPRING
Uganda's participatory approach to engage partners in the planning and implementation of key
interventions at national and district levels, reaffirmed support of SPRING's work plan, and welcomed
SPRING's collaboration in efforts to reduce the burden of malnutrition in SW Uganda. Other partners
were encouraged to emulate SPRING/Uganda.
IR 1: Improved utilization of preventive and treatment maternal and child nutrition services at facility
and community levels in SW Uganda
In addition to the continued support to the MOH in the process of finalization of the NACS training
package, SPRING/Uganda sought permission from the MOH to re-package the training manual and pre-
test its feasibility for use in on-site training. A two day re-packaging of the draft NACS training manual
was done in SPRING/Uganda offices in Mbarara, which included participation from three nutritionists
from Kabale, Mbarara and Sheema. The pre-test was held at Mbarara Regional Referral Hospital
between February 27- March 1, 2013 with 18 health workers from the nutrition unit, pediatric
outpatient department, anti-retroviral (ART) clinic, maternity ward, community department, children’s
ward and maternal child health clinic. The outcomes from the pre-test included the development of
departmental nutrition action plans and a revised NACS package for on-site training. The findings from
the pre-test were shared with the MOH and were used to refine the NACS training package in
collaboration with the FANTA project, which is to be pre-tested in Kisoro from April 22-26, 2013.
SPRING/Uganda is working closely with FANTA as a key partner in finalizing the training package.
Following the recruitment of Nutrition Specialists, active engagement in health facilities for
implementation of NACS interventions started in selected health facilities in Kisoro, Ntungamo and the
seven former NuLife-supported health facilities outside these two districts. The facilities reached
included: Kisoro Hospital, Mutolero Hospital, Rubuguri HCIV and Busanza HCIV in Kisoro; Itojo Hospital,
Kitwe HCIV, Rubaare and Rushamaire HCIV in Ntungamo; Kitagata Hospital in Sheema; Nyakibale
Hospital in Rukingiri, Kambuga Hospital in Kanungu; and Ibanda Hospital in Ibanda. The activities
implemented included on-site planning meetings with health workers, review of the client system flow,
and coaching and mentoring sessions through continuous medical education (CME). A total of 56 health
workers were reached this quarter. Systematic quality improvement, including coaching and
mentorship, and NACS service improvements will be conducted once the quality improvement trainings
for health workers are carried out in May 2013.
Throughout the quarter, SPRING/Uganda continued to progress its SBCC work. In March,
SPRING/Uganda developed a draft TOR for defining the project’s community mobilization strategy in
Kisoro and Ntungamo districts. The TOR outlines three phases of strategy development and
implementation, including formative work set to begin in May, materials adaptation and/or
development, and roll-out. On national level strategy development, the program participated in a
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February meeting organized by the OPM and FANTA in Kampala to review the draft national nutrition
advocacy strategy as well as the findings from the desk review of nutrition SBCC interventions in
Uganda. The final report from the desk review will be submitted to the OPM by FANTA in the coming
months. Thereafter, the OPM can officially give it to SPRING/Uganda to lead the development of the
national SBCC strategy for nutrition. With respect to this national work, SPRING/Uganda is developing a
scope of work for a consultant to support the strategy development process, starting in the next quarter
(Q3).
SPRING/Uganda actively participated in the launch of the Scaling Up Nutrition (SUN) Community
Program in the SW. The launch was held on February 23, 2013 in Muko Sub County, Kabale district and
presided over by the Prime Minister of the Republic of Uganda. He was accompanied by two other
Ministers of State and Area Members of Parliament. The Prime Minister and the State Ministers
emphasized the need for the SW to tackle the double burden of malnutrition they are currently facing,
despite being considered the food basket of the country. Other participants in the launch included
government ministries, representatives from 13 districts in the SW, a high level delegation from the US
Mission, UNICEF, the Food and Agriculture Organization, the United Nations High Commissioner for
Refugees, US implementing partners, community groups, and representatives from the local
communities. In total there were over 150 participants at the launch. SPRING/Uganda supported the
participation of district nutrition coordination focal persons, CAOs, DHOs and LCV chairpersons from
Kisoro and Ntungamo and worked with the USAID Community Connector project in conducting food
demonstrations during the launch.
The project also actively participated in the launch of the elimination of Mother-to-Child Transmission
(eMTCT) of HIV in the SW held on March 23, 2013 in Itojo Sub County, Ntungamo district. The launch of
the eMTCT strategy was presided over by the First Lady of the Republic of Uganda. It was organized by
the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Strengthening TB and AIDS Response in
Southwest Uganda (STAR-SW) project, the MOH and Ntungamo District Local Government, in
partnership with other implementing partners. During the launch, SPRING/Uganda displayed guidelines,
protocols, educational materials, and nutrition supplies for treatment of malnutrition and anemia. In
partnership with EGPAF/STAR-SW, SPRING/Uganda also conducted a food demonstration of the
different food groups locally available that can be used for nutritional rehabilitation and prevention of
malnutrition.
Prior to the eMTCT launch, SPRING/Uganda conducted pre-launch activities including a CME training on
NACS. Twenty-four participants participated in the training, including 23 females, three of whom were
permanent staff of Itojo Hospital from the ART, PNC/YCC and family planning clinics, while the
remainder were medical students from various medical training schools. In addition, client flow was
assessed by the in-charge of the ART clinic and the nutrition team with support from the Mbarara
Regional Hospital nutritionist. Nutrition action plans were also developed by the nutrition program
officers in the ART clinic. It was found during the pre-launch activities that staff had limited knowledge
on NACS, that nutrition assessment (particularly MUAC measurements) were not being properly
documented in patient registers, and that while a RUTAFA register exists in the ART clinic, the data is
poorly documented and client follow-up is not being done.
To complement facility-level activities, the SBCC team (advisor and specialists) conducted community
mobilization activities with the assistance of the Itojo Hospital Village Health Team (VHT) coordinator to
mobilize the population around eMTCT and service delivery during the launch day. During the launch,
112 clients, including 18 pregnant women, received nutrition assessment (height, weight and MUAC)
22
and nutrition counseling services. Three clients were found to be moderately malnourished, including
one pregnant woman, and two clients were severely malnourished.
IR 2: Increased dietary intake of vitamins and minerals
Finally, SPRING/Uganda also continued supporting the MOH in the national fortification work in food
fortification and home fortification initiatives. A meeting of stakeholders involved in food fortification
was held on March 6, 2013 to discuss the TOR and membership to the NWGFF. Members of the working
group agreed upon the TOR, and a small team was selected to edit and format the terms before they are
shared with the Director General of Health Services at the MOH. Letters to the selected organizations
for the nomination of members to the working group were sent out by the MOH with support from
SPRING/Uganda. An official inauguration of the group will be done in April 2013 with support from
SPRING/Uganda.
The protocol for the piloting of home fortification in Uganda is in the final stages of completion and
sharing with the government and members of the home fortification technical working group. Two
meetings were held this quarter to discuss the progress in developing the protocol, which were very
useful in providing answers to pending design questions. Significant development in relation to the pilot
is the acquisition of funding by WFP for the pilot; however, the decision on how they will work with the
rest of the partners is not yet clear. In line with the fortification work, several consultative meetings with
government parastatals, such as the National Drug Authority (NDA), the Uganda National Bureau of
Standards (UNBS), Private Sector Foundation Uganda, and the Ministries of Health and Agriculture, were
held to strategize how to effectively work with SPRING/Uganda to support the program. All the agencies
are willing to continue supporting the program and will be actively engaged once the technical group is
inaugurated in April 2013. Finally, SPRING/Uganda also participated in national micronutrient technical
working group meeting to discuss how to support the MOH in developing comprehensive guidelines on
micronutrients in Uganda. SPRING/Uganda has pledged to work with the MOH, UNICEF and other
partners to complete the guidelines.
The anemia evaluation work that SPRING is doing through its consultants, using DHS, was identified as
very important in informing the guidelines. A request was put forward to have the draft report to the
MOH as soon as it is ready.
Partnership for HIV Free Survival (PHFS) Activities
Throughout this quarter, SPRING/Uganda continued to actively engage in the preparation of the PHFS
implementation in Ntungamo, Kisoro and Namutumba districts. Through the planning meetings at
national level, a detailed six-month general work plan for the partnership was developed and presented
at the international launch of the partnership held in Pretoria, South Africa between March 11-14, 2013.
SPRING was represented at the launch by the SPRING/Uganda Program Manager and the SPRING/HQ
Technical Director. The Namutumba district planning meeting with district, NGO, MOH and
implementing partners (FANTA, ASSIST, SPRING and STAR-EC) was facilitated by SPRING/Uganda on
March 26, 2013. An action plan was developed and is being used to guide the PHFS activities in the
district. Detailed PHFS work plans for Namutumba, Kisoro and Ntungamo will be shared with the MOH
and partners in April 2013. SPRING/Uganda has begun recruiting new staff to support the PHFS work.
Activities Planned for Next Quarter (Q3):
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As described above, SPRING/Uganda, with technical support from SPRING/HQ staff, prepared a draft PIP
and detailed implementation plan for Q3 and Q4 (April to Sept 2013). The activities below are extracts of
key activities for the coming quarters.
1. Rolling out NACS training for facility-based providers in Kisoro, Ntungamo and Namutumba districts
in April and May 2013.
2. Fielding the first round of the monitoring and evaluation survey of community indicators in Kisoro,
Ntungamo and Namutumba districts, and two comparison districts in May and June 2013; and
fielding the facility survey in East Central.
3. Conducting training on quality improvement for district and site quality improvement teams in
Kisoro, Ntungamo and Namutumba in May and June 2013.
4. Conducting a landscape analysis for community mobilization and SBCC work in Kisoro and Ntungamo
in April 2013 and development of model for community mobilization. This will include orientation
and a skills development workshop for the SBCC team led by Save the Children.
5. Posting three success stories on the SPRING website.
6. Submitting the PEPFAR bi-annual report (15 April).
7. Submitting the SPRING/Uganda PMP.
8. Conducting formative research for designing an SBCC strategy in Kisoro and Ntungamo in May 2013.
9. Inaugurating the NWGFF, and developing and supporting implementation of a NWGFF detailed work
plan in May/June.
10. Supporting Uganda National Bureau of Standardsto assess the readiness of manufacturers for the
mandatory fortification regulation coming into force July 1, 2013, and preparing those who need
technical support.
11. Conducting on-site mentorship and coaching of health workers on NACS between April-June 2013.
12. Rolling out PHFS activities in line with the national six-month plan.
13. Q3 progress review and planning for Q4.
14. Completing the Ntungamo district nutrition plan.
15. Establishing field offices in Kisoro, Ntungamo and Namutumba.
16. Completing procurement of key nutrition supplies and equipment to support operations and
program implementation.
17. Reviewing operational support structure, including the staffing plan, in view of program
implementation needs and reorganize as needed.
18. Completing the SPRING/Uganda Human Resources Manual and Operations Manual.
24
IV. Knowledge Management
The KM Team has continued to provide support to both the core and country SPRING teams. KM
managed the production and finalization of four deliverables this quarter:
1. SPRING/Bangladesh promotional materials, including an updated SPRING one pager that now
describes SPRING/Bangladesh’s key indicators and the development of a tri-fold
SPRING/Bangladesh brochure.
2. Finalization of the Nigeria IYCF packet, including a participant’s guide, a facilitator’s guide
counseling tools, brochures, and job aids. This is an extensive set of materials that were initially
developed by the IYCN Project in Nigeria. SPRING updated the materials, finalized the products
and printed them for use in Nigeria.
3. SPRING finalized and translated the report titled: Report on Findings from an Assessment of the
Integration of Nutrition into HIV Programs in Selected Facilities and Communities in Haiti. The
report has been disseminated by the country team in Haiti.
4. IFA Briefs –These documents consist of one regional and four country briefs that explore DHS
data to provide a rapid assessment tool of how well the antenatal care system distributes IFA in
each country. Additional geographic and social analyses provide guidance for future research
into weaknesses that may exist in the countries’ antenatal care system. More country briefs are
being developed and should be ready in the next quarter.
Website/Intranet development: During this reporting period, the KM Team continued to develop the
project’s intranet to better connect SPRING staff and partners based in the U.S. and at country-level.
This includes discussion boards designed to facilitate communication focused on coordinating efforts
and ensuring that each country office is implementing activities in harmony with SPRING’s framework
and technical approach. In addition, the SPRING website saw significant growth, including the addition
of the publications section that currently hosts 11 documents. In addition, the KM Team devoted a
significant amount of time developing the Events section of the site, which now hosts presentations,
videos, and materials from the three regional AgN-GLEE workshops. The KM Team began content
development for each country program and will soon launch this section of the website to highlight the
project’s work in Nigeria, Uganda, Bangladesh and Haiti.
This quarter, the website received 9,884 page views from 1,568 unique visitors from across 101
countries.
AgN-GLEE: The KM Team continued their heavy involvement in the planning and executing of two AgN-
GLEE workshops, in the LAC and Asia region. In particular,
• KM facilitated a knowledge sharing session during both the LAC and Asia workshops. The
objectives of the session were to engage participants to identify continued learning
opportunities following the AgN-GLEE workshop.
• The KM Team managed the registration process again for both workshops, produced the
workshop packets, and supported the logistical aspects of the workshops. Materials and
presentations are posted on the SPRING website as well as video interviews taken from the
workshop.
• The KM Team has participated developing a knowledge management strategy to capitalize on
momentum from the workshops and foster collaboration continued learning among
participants and other interested in agriculture-nutrition linkages.
25
KM partnerships: The KM Team formalized a link with the BFS-funded AgriLinks knowledge platform,
and was able to create a site/group for the participants to join on AgriLinks. This group will be formally
introduced and launched in the next quarter. SecureNutrition featured SPRING’s AgN-GLEE Workshops
in their monthly newsletter. Feed the Future also featured SPRING/BFS work on the workshops in their
newsletter.
Support to country teams: The KM team worked closely with the Bangladesh team to finalize the
promotional materials. It also supported the efforts that Uganda made in participating in the SUN
Launch that was held in Uganda. KM also provided support to Haiti’s IYCN counseling cards that are
being used for an in-country training.
SPRING Facebook page: Since May 2012, SPRING’s Facebook page garnered:
• 114 – total likes, the number of unique people who like the SPRING Facebook page.
• 50,258 – friends of fans, the number of unique people who are friends with your fans, including
your current fans.
Next Quarter
In the next quarter SPRING will:
• Work closely with BFS to develop a work plan for the BFS funded work around KM.
• Bring new staff on board in order to meet the growing KM needs and the BFS work
• Develop country pages on the SPRING website to better highlight their work/ activities
• Provide country support on an “as-needed” basis
26
V. Operations, Finance, And Management
SPRING had a productive second quarter. With the Year 2 Work Plan approved, SPRING dedicated this
quarter to implementing the work plan and to rapidly move forward with identified priority activities.
SPRING completed the recruitment and hiring of several positions including the Technical Director,
Monitoring & Evaluation Analyst, and a Communications Officer to support our growing project. With a
fully staffed Project Management Team (PMT), the PMT held a retreat to discuss and clarify overall PMT
roles and responsibilities and clarify the role of the individual members. Outcomes of the PMT meetings,
including refined operating norms and communication strategies, will be shared with project staff during
the upcoming SPRING Project Retreat next quarter. As SPRING grows, these are all efforts to ensure an
efficient and effective project management structure.
In January 2013, SPRING conducted its second Partner Advisory Group (PAG) meeting. The PAG meeting
allowed SPRING partners to provide feedback and ensured that the PAG was abreast of any current
developments. The successful meeting focused on core and country implementation updates, revised
SPRING policies and procedures, technical and financial updates and a discussion on management and
operations.
During this quarter, SPRING expanded its internal intranet as the project continued to implement and
fine-tune policies and project-wide processes. The KM team, in collaboration with the finance and
operations team, developed a travel section and revised the calendar and forum platforms to better
operationalize these processes and procedures.
Next Quarter
In the next quarter SPRING will:
• Host a SPRING Project Retreat
• Host a Country Manager’s Meeting
• Expanded external website
• Recruit for new identified positions (BFS)
29
VI. Performance Monitoring Plan and Progress Tracking
SPRING Performance Monitoring Plan - Indicators by Results Framework SO and IRs
No. Indicator
Achievements
FY13
Q1 Q2
Strategic Objective: Policies and Programs to scale up effective nutrition services improved*
1 Number of children under five reached by USG-supported
nutrition programs 34,206 128,125
2 Number of children under five who received vitamin A from USG-
supported programs 0 0
3 Number of countries with introductions and/or expansions of
cutting edge nutrition interventions Measured and reported on
an annual basis.
IR 1: Country specific approaches to scale up nutrition programs improved*
1.1 Number of situational analysis/ landscape analysis carried out by
SPRING 3 4
1.2 Number of people trained in child health and nutrition through
USG-supported health area programs 1,693 2,863
1.3 Number of facilities or services (e.g., health facilities, farmer field
schools, others) reached with SPRING support 2,350 945
1.4 Number of institutions reached with SPRING support 12 15
1.5 Number of health facilities with established capacity to manage
acute under-nutrition Measured and reported on
an annual basis.
1.6 Number of instances of technical assistance provided to SPRING-
supported countries 18 28
Sub-Result 1.1: Country-specific SBCC programs strengthened
1.1.1 Estimated number of contacts made through SBCC activities 45,468 175,698
1.1.2 Number of people accessing nutrition e-learning module N/A N/A
Sub-Result 1.2: Country-specific approaches to improve dietary quality and diversity (including
micronutrient adequacy) advanced
See indicators 1.2, 1.3, 1.4, 1.6
Sub-Result 1.3: Country-specific scale-up of evidence based nutrition interventions supported
1.3.1 Number of geographic units reached by SPRING activities 47 54
30
SPRING Performance Monitoring Plan - Indicators by Results Framework SO and IRs
No. Indicator
Achievements
FY13
Q1 Q2
1.3.2 Percent of geographic units in the country reached by SPRING
activities See Appendix 2, Table 6.
1.3.3 Percent of target population reached on SPRING -supported
geographic units Measured and reported on
an annual basis.
IR 2: Global evidence base, advocacy platforms, and policies for nutrition expanded
2.1 Number and type of dissemination activities supported by
SPRING 3 86
Sub-Result 2.1: Policy and advocacy efforts to support food and nutrition policies and programming
strengthened
2.1.1 Number of country, regional, and global meetings conducted or
attended 7 6
2.1.2 Number of networks or community of practice groups that
SPRING leads or participates in 20 20
Sub-Result 2.2: Evidence base learning, monitoring and evaluation for effective approaches to scale-
up nutrition services expanded
2.2.1 Number of research and evaluation activities conducted by
SPRING 18 21
2.2.2 Number of instances where standard nutrition metrics are
improved based on SPRING inputs Measured and reported on
an annual basis.
2.2.3 Number of documents (reports, tools, statements) produced by
SPRING 4 completed;
1 finalized
6 completed;
6 finalized
2.2.4 Number of unique visits to SPRING website 734 1,568
* Note: Objective level and IR1 indicators primarily represent SPRING's work funded through Field
Support. Some of the indicators will only be measured in countries with substantial SPRING support
related to the activity being measured (e.g., Vitamin A). Additional indicators demonstrating
achievements at the country level will be developed as part of each country's PMP, and country-level
indicators will therefore vary by country.
31
Appendix 1: Quarter 2 Trip Reports
DATES
Traveler Country Purpose START
DATE
END
DATE
1/8/2013 1/25/2013 Marjolein
Moreaux Haiti
To provide support in the development of a facility-
level -IYCF training package that complements the
former IYCN-supported job aids and the draft national
protocol for the provisional package of NACS services
in Haiti.
1/27/2013 2/15/2013 Peggy Koniz-
Booher India
To review plans for finalizing the formative research
report; support the Maternal Infant and Young Child
Community Nutrition Training in Keonjhar District,
Odisha; and meet with partners in New Delhi to
debrief and review the plans and timeline for
conducting the feasibility study.
2/9/2013 2/22/2013 Alexis
D’Agostino Uganda
To work with the country team for the development
of a country-level PMP; To meet with the National
Micronutrient Technical Working Group and other
stakeholders to plan for the national MMP
acceptability and feasibility study; To develop aSOW,
recruitment and logistics plan for the SPRING baseline
community assessment; To assist with carrying out a
Logistics Systems Assessment Tool; To work with
SPRING’s research consultant to review and plan
further analysis of the Uganda 2011 DHS.
2/8/2013 3/1/2013 Hana
Nekatebeb Uganda
To prepare for and participate in the Health Facility
Assessment results dissemination workshop and
detailed planning workshop discussion; To facilitate
the development of an implementation plan for
increasing use of preventive and treatment services
both at facility and community levels and increasing
dietary intake of vitamins and minerals nationally; To
work with the country team to adapt the national
NACS training manual, pretest the training manual in
one facility, in close collaboration with
SPRING/Uganda’s main implementing partnerEGPAF,
and finalize the training manual.
2/10/2013 2/16/2013 Tobias Stillman Uganda
To provide technical assistance during the detailed
planning workshop discussion on the design of rolling
out preventive and treatment services in Uganda; To
help facilitate the development of an implementation
plan for increasing use of preventive and treatment
services both at facility and community levels and
increasing dietary intake of vitamins and minerals
nationally; To discuss project performance and global
support needs through meetings with various USAID,
government and NGO stakeholder meetings.
2/10/2013 2/22/2013 Timothy
Uganda To carry out a qualitative assessment of supply chains
for various nutrition-related products, such as iron-
32
Williams folic acid (IFA) tablets, vitamin A, deworming and
malaria prevention products; To participate in SPRING
implementation plan meetings and contribute to work
planning and monitoring of the work plan; To provide
training and orientation to SPRING/Uganda strategic
information (SI) staff.
2/22/2013 3/09/2013 Ryan
Macabasco Bangladesh
To provide on-the-ground programmatic support to
the SPRING/Bangladesh team that would help better
align global SPRING efforts with country activities and
look for ways to strengthen SPRING/Bangladesh’s
ongoing execution of programmatic activities.
2/27/2013 3/12/2013 Anges Guyon Benin
Test ENA-EHA training within FITU (Focus In Training
Up) Peace Corps strategy and conducting regional
training of trainers with five Peace Corps country
teams.
3/1/2013 3/9/2013 Kristina Beall
India
Provide technical assistance and support following the
Maternal, Infant and Young Child Community Training
and during the creation and dissemination of the first
set of videos for the SPRING/Digital Green
collaboration.
3/2/2013 3/8/2013
Alyssa Klein,
Christian
Winger, Carrie
Lyons, Heather
Danton, John
Nicholson, Kim
Peacock,
Kristen Kappos,
Lidan Du,
Samantha Clark
Guatemala The purpose of this trip was to conduct and provide
technical and operational support for the AgN-GLEE in
Guatemala City, Guatemala from March 5-7, 2013.
3/16/2013 3/27/2013
Aaron
Buchsbaum,
Aaron Hawkins,
Antonia Wolff,
Anuradha
Narayan, David
Paprocki, Daniel
Cothran,
Heather
Danton, John
Nicholson,
Lidan Du,
Samantha Clark
Thailand The purpose of this trip was to conduct and provide
technical and operational support for theAAgN-GLEE
in Bangkok, Thailand from March 19-21, 2013.
33
Appendix 2: Supplementary Information on Selected
Program Monitoring Indicators (Q2)
Country- & region-specific situational/landscape analyses carried out by SPRING (PMP Indicator 1.1)
During this quarter the following country/regional-level situation analyses/landscape analyses were
finalized:
- Formative research for the adaptation of the Digital Green (DG) approach to promoting nutrition
practices in Orissa, India
- Uganda NACS Assessment
- Ag-NGLEE Landscape Analysis – Latin America
- Ag-NGLEE Landscape Analysis – Asia
People trained in child health and nutrition through USG-supported health area programs (PMP
Indicator 1.2)
SPRING conducted 106 trainings for multiple cadres of Bangladesh’s health system (including master
trainers, MoHFW supervisors, frontline health workers, community health workers, and family planning
workers) on ENA, EHA/WASH, breastfeeding, and complementary feeding issues. In addition, 19
trainings were conducted elsewhere, as summarized in Figure 1 and described in detail in Table 4. (Table
4 does not include details for each training in Bangladesh due to space issues.) Topics included clinical
nutritional assessment, HIV/Nutrition Integration, and IYCF. Two trainings, conducted in Benin,
instructed Peace Corps Volunteer trainers based in West Africa on ENA and EHA. In total, 2,863 people
were trained in 125 trainings during Quarter 2.
Figure 2. Numbers of people trained and trainings, by country (excluding Bangladesh*)
* This graph exclues data from Bangladesh so as not to skew the graph.
34
Table 4. List of trainings conducted
LOC. TITLE # OF PEOPLE TRAINED
COMMENTS/DESCRIPTION TOTAL
BY GENDER MALE FEMALE
Bangla-
desh [Various] 2,548 1,350 1,198
In total, 106 training sessions were conducted on
ENA, EHA/WASH, breastfeeding &
complementary feeding at multiple levels of the
health care system.
Haiti
Use of Weight-
Height Table &
Weight gain
table/BMI
2 1 1
Half day-training by MIYCN Activity Coordinator,
Technical Training Advisor during planned
reinforcement visit to HF. Tables were
distributed.
Haiti Use of Weight-
Height Table 2 0 2
Half day-training by MIYCN Activity Coordinator,
Technical Training Advisor during planned
reinforcement visit to HF. Tables were
distributed.
Haiti Counseling 5 0 5
Half day-training by MIYCN Activity Coordinator,
Technical Training Advisor during planned
reinforcement visit to HF. Worked with group of
5 going through the IYCN counseling tool, giving
them time to practice and ask questions.
Counseling tools were distributed.
Haiti
Nutritional
Assessment &
Support
24 6 18
One-day reinforcement session by Technical
Advisor - NACS and Strategic Planning on
Nutritional Assessment and Support and MIYCN
Activity Coordinator, Technical Training Advisor
at Hopital Universitaire Universite Justinien.
Focal Point and Assistant participated in the
session.
Haiti
Nutritional
Assessment &
Support
13 5 8
One-day reinforcement session by Technical
Advisor MIYCN Activity Coordinator, Technical
Training Advisor on Nutritional Assessment and
Support. Material distributed.
Haiti Anthropo-
metric Training 7 5 2
Three-day training organized by MEASURE
Evaluation. Training was essentially for MSPP
personnel and health facilities participating in
MEASURE Nutrition Surveillance. Key personnel
from two SPRING health facilities in the West
were invited: Hopital Maternite de Carrefour and
Hopital Universitaire La Paix.
Haiti Anthropo-
metric Training 4 1 3
Three-day training organized by MEASURE
Evaluation. Training was essentially for MSPP
personnel and health facilities participating in
MEASURE Nutrition Surveillance. Key personnel
from two SPRING health facilities in the
Artibonite were invited: Hopital St Nicolas and
35
Table 4. List of trainings conducted
LOC. TITLE # OF PEOPLE TRAINED COMMENTS/DESCRIPTION
Hopital Alma Mater de Gros Morne.
Haiti Anthropo-
metric Training 5 0 5
Three-day training organized by MEASURE
Evaluation. Training was essentially for MSPP
personnel and health facilities participating in
MEASURE Nutrition Surveillance. Key personnel
from two SPRING health facilities in the North
were invited: Hopital Universitaire Justinien and
Hopital Sacre Coeur de Milot
Nigeria C-IYCF and
M&E Training 24 4 21
Trained community volunteers and health
workers in charge of health facilities in Zaki-Biam
on C-IYCF & basic data monitoring tools.
Nigeria C-IYCF and
M&E Training 24 12 12
Trained community volunteers and health
workers in charge of health facilities in
Vandenkiya LGA on C-IYCF & basic data
monitoring tools.
Nigeria
C-IYCF
Refresher and
M&E Training
24 4 20
Trained community volunteers and health
workers in charge of health facilities in Kuje LGA
on C-IYCF & basic data monitoring tools.
Nigeria
C-IYCF
Refresher and
M&E Training
25 3 22
Trained community volunteers and health
workers in charge of health facilities in Abaji on
C-IYCF & basic data monitoring tools.
Uganda NACS training
field test 18 3 15
Facility-based training of health workers on NACS
– a training manual usability field test after
curriculum redesign
Uganda
Continuous
Medical
Education on
NACS
30 12 18
This was also as a preparatory activity for the
launch of the PMTCT Option B + for eMTCT.
Processes and systems design in the ART clinic,
ANC, YCC and paediatric wards for NACS
integration were done in 2 health facilities: Itojo
Hospital and Kitwe HC IV.Two (2) health worker
education (C.M.E) sessions were held in the 2
facilities.
36
Table 4. List of trainings conducted
LOC. TITLE # OF PEOPLE TRAINED COMMENTS/DESCRIPTION
Uganda
Continuous
Medical
Education on
NACS
15
15 community health workers (VHTs) were
sensitised on the communication messages for
NACS and PMTCT option B +
Uganda
Integrating
NACS into
Routine Health
Care
10 3 7
SPRING conducted a Continuous Medical
Education on NACS and its implementation in all
the contact points in the health facility setting.
SPRING provided learning materials
Uganda
Integrating
NACS into
Routine Health
Care
24 3 21
SPRING conducted a Continuous Medical
Education on NACS and its implementation in all
the contact points in the health facility setting.
SPRING provided learning materials. This was
part of the service delivery activities towards the
launch of eMTCT OPTION B+ at Itojo
Other Peace Corps
TOT 32 16 16
Training of Trainers on ENA-EHA, co-funded by
Peace Corps, West Africa Food Security
Partnership and SPRING. Five countries attended.
Other
Peace Corps
Cascade
Training
27 24 12
Cascade training of volunteers and counterparts
on ENA-EHA. Co-funded by Peace Corps, West
Africa Food Security Partnership and SPRING.
Instances of technical assistance provided to SPRING-supported countries (PMP Indicator 1.6)
Technical assistance (TA) is defined as support provided by SPRING (including SPRING staff and
consultants) to country programs during TDY trips. Throughout the quarter, there were 28 instances of
TA, including 9 in Guatemala City, Guatemala, and 10 in Bangkok, Thailand for AgN-GLEE workshops. 4
were in Uganda and covered SI, program development, micronutrient deficiencies, and HIV-nutrition
integration. Table 5 provides a detailed description of each TA provided.
Table 5. Technical assistance provided by SPRING
DATES
TA Provider
Country
receiving
TA
Description START
DATE
END
DATE
1/8/2013 1/25/2013 Marjolein
Moreaux Haiti
To provide support in the development of a facility-
level infant and young child feeding (IYCF) training
package that complements the former Infant & Young
Child Nutrition (IYCN)-supported job aids and the
draft national protocol for the provisional package of
NACS services in Haiti.
1/27/2013 2/15/2013 Peggy Koniz-
Booher India
To review plans for finalizing the formative research
report; support the Maternal Infant and Young Child
Community Nutrition Training in Keonjhar District,
Odisha; and meet with partners in New Delhi to
debrief and review the plans and timeline for
37
Table 5. Technical assistance provided by SPRING
DATES TA Provider Country
receiving Description
conducting the feasibility study.
2/9/2013 2/22/2013 Alexis
D’Agostino Uganda
To work with the country team for the development
of a country-level Performance Monitoring Plan
(PMP); To meet with the National Micronutrient
Technical Working Group and other stakeholders to
plan for the national multiple micronutrient powders
(MMP) acceptability and feasibility study; To develop
a statement of work, recruitment and logistics plan
for the SPRING baseline community assessment; To
assist with carrying out a Logistics Systems
Assessment Tool; To work with SPRING’s research
consultant to review and plan further analysis of the
Uganda 2011 Demographic and Health Survey.
2/8/2013 3/1/2013 Hana
Nekatebeb Uganda
To prepare for and participate in the Health Facility
Assessment results dissemination workshop and
detailed planning workshop discussion; To facilitate
the development of an implementation plan for
increasing use of preventive and treatment services
both at facility and community levels and increasing
dietary intake of vitamins and minerals nationally; To
work with the country team to adapt the national
Nutrition Assessment, Counseling and Support (NACS)
training manual, pretest the training manual in one
facility, in close collaboration with SPRING/Uganda’s
main implementing partner [Elizabeth Glaser Pediatric
Aids Foundation (EGPAF)], and finalize the training
manual.
2/10/2013 2/16/2013 Tobias Stillman Uganda
To provide technical assistance during the detailed
planning workshop discussion on the design of rolling
out preventive and treatment services in Uganda; To
help facilitate the development of an implementation
plan for increasing use of preventive and treatment
services both at facility and community levels and
increasing dietary intake of vitamins and minerals
nationally; To discuss project performance and global
support needs through meetings with various USAID,
government and NGO stakeholder meetings.
2/10/2013 2/22/2013 Timothy
Williams Uganda
To carry out a qualitative assessment of supply chains
for various nutrition-related products, such as iron-
folic acid (IFA) tablets, vitamin A, deworming and
malaria prevention products; To participate in SPRING
implementation plan meetings and contribute to work
planning and monitoring of the work plan; To provide
training and orientation to SPRING/Uganda strategic
information (SI) staff.
38
Table 5. Technical assistance provided by SPRING
DATES TA Provider Country
receiving Description
2/22/2013 3/09/2013 Ryan
Macabasco Bangladesh
The objective was to provide on-the-ground
programmatic support to the SPRING/Bangladesh
team that would help better align global SPRING
efforts with country activities and look for ways to
strengthen SPRING/Bangladesh’s ongoing execution
of programmatic activities.
2/27/2013 3/12/2013 Agnes Guyon Benin
Test ENA-EHA training within FITU (Focus In Training
Up) Peace Corps strategy and conducting regional
training of trainers with five Peace Corps country
teams.
3/1/2013 3/9/2013 Kristina Beall
India
Provide technical assistance and support following the
Maternal, Infant and Young Child Community Training
and during the creation and dissemination of the first
set of videos for the SPRING/Digital Green
collaboration.
3/2/2013 3/8/2013
Alyssa Klein,
Christian
Winger, Carrie
Lyons, Heather
Danton, John
Nicholson, Kim
Peacock,
Kristen Kappos,
Lidan Du,
Samantha Clark
Guatemala
The purpose of this trip was to conduct and provide
technical and operational support for the Agriculture-
Nutrition Global Learning and Evidence Exchange
workshop (AgN-GLEE) in Guatemala City, Guatemala
from March 5-7, 2013.
3/16/2013 3/27/2013
Aaron
Buchsbaum,
Aaron Hawkins,
Antonia Wolff,
Anuradha
Narayan, David
Paprocki, Daniel
Cothran,
Heather
Danton, John
Nicholson,
Lidan Du,
Samantha Clark
Thailand
The purpose of this trip was to conduct and provide
technical and operational support for the Agriculture-
Nutrition Global Learning and Evidence Exchange
workshop (AgN-GLEE) in Bangkok, Thailand from
March 19-21, 2013.
39
Co
ve
rag
e a
nd
re
ach
of
SPR
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try
act
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ies
(PM
P I
nd
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1.3
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f SP
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an
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(e.g
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SP
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ntr
y a
ctiv
itie
s
Co
un
try
Inst
itu
tio
ns
(go
ve
rnm
en
t o
r N
GO
)
rece
ivin
g S
PR
ING
su
pp
ort
De
scri
pti
on
of
act
ivit
ies
Ba
ng
lad
esh
T
he
Hu
ng
er
Pro
ject
E
NH
A t
rain
ing
th
rou
gh
"P
ee
r Fa
cili
tati
on
" tr
ain
ing
so
th
at
the
y ca
n d
eli
ver
nu
trit
ion
al
me
ssa
ge
s to
ta
rge
t b
en
efi
cia
rie
s. A
lso
pro
vid
ed
a r
ou
tin
e m
on
ito
rin
g t
oo
l an
d s
up
po
rtiv
e
sup
erv
isio
n c
he
ckli
st.
Ba
ng
lad
esh
R
FLD
C-B
ari
sal (
Go
B-D
an
ida
) Se
e a
bo
ve
Ba
ng
lad
esh
W
orl
dFi
sh
See
ab
ove
Ha
iti
MSP
P (
thro
ug
h p
ub
lic
inst
itu
tio
ns/
MA
TS
site
s w
ith
WH
O
sup
po
rt)
Faci
lita
tin
g b
rea
stfe
ed
ing
mo
du
les
in t
rain
ing
s o
rga
niz
ed
by
MSP
P w
ith
WH
O s
up
po
rt f
or
he
alt
h w
ork
ers
fro
m p
ub
lic
faci
liti
es.
Nig
eri
a B
en
ue
Sta
te M
inis
try
of
He
alt
h
Tra
inin
g o
f co
mm
un
ity
volu
nte
ers
an
d h
ea
lth
wo
rke
rs (
off
ice
r in
ch
arg
e o
f H
ea
lth
Faci
liti
es)
on
Co
mm
un
ity
Infa
nt
Yo
un
g C
hil
d F
ee
din
g (
C-I
YC
F) t
rain
ing
pa
cka
ge
an
d b
asi
c C
-
IYC
F d
ata
co
lle
ctio
n
Nig
eri
a U
kum
LG
A
Tra
inin
g o
f co
mm
un
ity
volu
nte
ers
an
d h
ea
lth
wo
rke
rs (
off
ice
r in
ch
arg
e o
f H
ea
lth
Faci
liti
es)
on
Co
mm
un
ity
Infa
nt
Yo
un
g C
hil
d F
ee
din
g (
C-I
YC
F) t
rain
ing
pa
cka
ge
an
d b
asi
c C
-
IYC
F d
ata
co
lle
ctio
n
Nig
eri
a V
en
de
ikya
LG
A
Tra
inin
g o
f co
mm
un
ity
volu
nte
ers
an
d h
ea
lth
wo
rke
rs (
off
ice
r in
ch
arg
e o
f H
ea
lth
Faci
liti
es)
on
Co
mm
un
ity
Infa
nt
Yo
un
g C
hil
d F
ee
din
g (
C-I
YC
F) t
rain
ing
pa
cka
ge
an
d b
asi
c C
-
IYC
F d
ata
co
lle
ctio
n
Nig
eri
a FC
T P
rim
ary
He
alt
h C
are
De
velo
pm
en
t A
gen
cy
Tra
inin
g o
f co
mm
un
ity
volu
nte
ers
an
d h
ea
lth
wo
rke
rs (
i/c
of
He
alt
h F
aci
liti
es)
on
C-I
YC
F
an
d b
asi
c C
-IY
CF
da
ta m
on
ito
rin
g t
oo
ls
Nig
eri
a A
ba
ji A
rea
Co
un
cil
Tra
inin
g o
f co
mm
un
ity
volu
nte
ers
an
d h
ea
lth
wo
rke
rs (
i/c
of
He
alt
h F
aci
liti
es)
on
C-I
YC
F
an
d b
asi
c C
-IY
CF
da
ta m
on
ito
rin
g t
oo
ls
Ug
an
da
Off
ice
of
the
Pri
me
Min
iste
r T
ech
nic
al s
up
po
rt in
de
velo
pin
g g
uid
e f
or
ori
en
tin
g d
istr
ict
nu
trit
ion
co
ord
ina
tio
n
com
mit
tee
s; t
ech
nic
al s
up
po
rt in
de
velo
pin
g n
utr
itio
n a
dvo
cacy
str
ate
gy
for
Ug
an
da
un
de
r
UN
AP
Ug
an
da
Min
istr
y o
f H
ea
lth
T
ech
nic
al s
up
po
rt in
de
velo
pin
g N
AC
S tr
ain
ing
ma
teri
als;
de
velo
pin
g p
roto
col f
or
pil
oti
ng
ho
me
fo
rtif
ica
tio
n in
itia
tive
in U
ga
nd
a
Ug
an
da
Kis
oro
Dis
tric
t Lo
cal G
ove
rnm
en
t O
rie
nta
tio
n o
f d
istr
ict
nu
trit
ion
co
ord
ina
tio
n c
om
mit
tee
Ug
an
da
Ntu
ng
am
o D
istr
ict
Loca
l Go
vern
me
nt
Ori
en
tati
on
of
dis
tric
t n
utr
itio
n c
oo
rdin
ati
on
co
mm
itte
e
Ug
an
da
Do
cto
rs f
or
Glo
ba
l He
alt
h
Co
nce
pt
no
te d
eve
lop
ed
fo
r co
lla
bo
rati
on
wit
h o
rga
niz
ati
on
. C
on
sult
an
t fr
om
SC
an
d
SPR
ING
/Ug
an
da
Pro
ject
Ma
na
ge
r vi
site
d t
o lo
ok
at
spe
cifi
c co
mp
on
en
ts.
41
Ta
ble
9.
Nu
mb
er
of
pe
op
le r
ea
che
d b
y S
PR
ING
co
un
try
act
ivit
ies
LOC
AT
ION
ES
TIM
AT
ED
NU
MB
ER
OF
PE
OP
LE R
EA
CH
ED
CO
MM
EN
TS
/DE
SC
RIP
TIO
N
TO
TA
L B
Y G
EN
DE
R
CH
ILD
RE
N <
5
MA
LE
FEM
ALE
Ba
ng
lad
esh
1
41
,48
1
0
14
,14
81
1
04
,67
8
De
live
r E
NH
A m
ess
ag
es
thro
ug
h g
ove
rnm
en
t fr
on
tlin
e
he
alt
h w
ork
ers
pro
vid
ing
on
e-o
n-o
ne
, fa
cili
ty-b
ase
d
cou
nse
lin
g
Ba
ng
lad
esh
2
9,2
17
0
2
9,2
17
2
3,4
47
D
eli
ver
agri
cult
ure
, po
ult
ry a
nd
EN
HA
su
pp
ort
th
rou
gh
de
mo
nst
rati
on
fa
rme
r fi
eld
sch
oo
ls
Ug
an
da
5,0
00
Lau
nch
of
eM
TC
T O
pti
on
B+
co
mm
un
ity
eve
n/c
am
pa
ign
wit
h S
BC
C.
Sin
ce t
his
wa
s a
com
mu
nit
y e
ven
t it
is n
ot
po
ssib
le t
o c
oll
ect
an
exa
ct
nu
mb
er
of
pe
op
le r
ea
che
d.
Th
is is
ou
r b
est
est
ima
te.
42
Number of country, regional, and global meetings conducted or attended (PMP Indicator 2.1.1)
SPRING was active in the global dialogue on nutrition during the past quarter, participating in five major
meetings and conferences and presenting at three of those meetings, and hosting two of them. The
topics were wide-ranging, covering agriculture-nutrition linkages, NCDs, SI, and HIV-nutrition
integration.The five major meetings in which SPRING participated are detailed in Table 10 below.
Descriptions of meetings from other quarters are available in the quarterly reports.
Table 10 Country, regional, and global meetings conducted or attended by SPRING
Date Title (Location)
SPRING
hosted/
organized
SPRING staff
attending
SPRING
presented Description
26-
Mar-
13
SPRING Extended
Cost
Effectiveness
Model for
Nutrition
Interventions:
Preliminary
Results
No Amanda
Pomeroy
Christian
Winger
Jolene Wun
Yes Presentation of preliminary
results of the NCD simulation
model to Ariel Pablos-Mendez of
USAID and Robert Black of Johns
Hopkins School of Public Health
20-
Feb-
13
Secure Nutrition
Advisory Board
Meeting
No Christian
Winger
No This was an opportunity to share
SecureNutrition's ongoing and
planned activities for 2013, as
well as to discuss opportunities
for SecureNutrition post-2014.
19-
Mar-
13
Agriculture and
Nutrition Global
Learning and
Evidence
Exchange
Yes Anuradha
Narayan,
Aaron
Hawkins,
Samantha
Clark, John
Nicholson,
Daniel
Cothran,
Antonia Wolff
Yes In Bangkok, Thailand. See AgN-
GLEE Trip reports.
11-
Mar-
13
Partnership for
HIV Free Survival
Launch
No Toby Stillman No The Partnership for HIV-Free
Survival (PHFS) is a six-country
initiative (Tanzania, Kenya,
Uganda, Mozambique, Lesotho
and South Africa) designed to
assist the countries with their
current national efforts to
improve postnatal HIV, maternal,
and infant care and nutrition
support through effective
implementation of the 2010
WHO Guidelines on HIV and
43
Table 10 Country, regional, and global meetings conducted or attended by SPRING
Date Title (Location)
SPRING
hosted/
organized
SPRING staff
attending
SPRING
presented Description
Infant Feeding.
5-
Mar-
13
Agriculture and
Nutrition Global
Learning and
Evidence
Exchange
Yes Christian
Winger,
Samantha
Clark, John
Nicholson,
Carrie Lyons,
Kristen
Kappos, Peggy
Koniz-Booher
Yes In Guatemala City, Guatemala.
See AgN-GLEE Trip reports.
Number of networks or community of practice groups that SPRING leads or participates in (PMP
Indicator 2.1.2)
SPRING HQ also led and/or participated in a total of 20 networks/communities of practice groups
involved in malnutrition efforts:
- 1000 Days Advocacy Group
- CORE Group Nutrition Working Group
- CORE Group SBCC Working Group
- MCHIP’s MIYCN-FP Technical Working Group
- FSN Network – Knowledge Management Task Force
- IASC Global Nutrition Cluster
- IATT Working Group on Infant and Child Survival
- Interagency working group on community health worker performance
- mHealth Working Group (interagency)
- NYAS nutrition research agenda working group - delivery science focus area
- Secure Nutrition
- Social Media Interagency Working Group
- Alive & Thrive (A&T)
- Partnership for HIV-Free Survival (PHFS)
- Anemia Task Force
- mHealth Technical Working Group
- TOPS Food Security and Nutrition (FSN) Network
- FSN Network – Social & Behavioral Change (SBC) Task Force
- Scaling Up Nutrition (SUN) – Civil Society Organizations (CSO) Network
- Agriculture-Nutrition Community of Practice
44
Research and evaluation activities conducted by SPRING (Indicator 2.2.1)
During this quarter a number of research and evaluation activities were underway:
- SBCC literature review
- Research on the current state of mHealth for nutrition in terms of literature and projects
- Study of the feasibility of adapting the Digital Green (DG) approach to promoting nutrition
practices in Orissa, India
- Analysis of IFA provision and consumption across high-burden countries
- Assessment of Uganda IFA supply chain (draft report completed)
- Baseline assessment of acceptability and compliance to use of MMPs in Uganda (draft protocol
developed)
- Standardization of streamlined tools for health facility assessments of nutrition services (NACS)
(draft tools developed)
- Nutrition workforce capacity assessment (draft protocol developed)
- Analysis and documentation country-level efforts to reduce undernutrition over time
("Pathways to Better Nutrition" Case Studies)
- HCES re-analysis (Bangladesh, Uganda, and Nigeria)
- Literature review of delivery science of nutrition programs (NYAS)
- Analysis and model on the relationship of early life undernutrition and undernutrition
programming on risk of later life non-communicable disease (NCD)
- Bangladesh baseline (FSNSP) survey supported
- Bangladesh monitoring system and tools developed
- Bangladesh nutrition and agriculture formative research
The following research and evaluation activities were completed:
- Assessment of the economic feasiblity of maize meal fortification (case studies on Kenya,
Uganda and Zambia)
- Formative research for the adaptation of the Digital Green (DG) approach to promoting nutrition
practices in Orissa, India
- Uganda NACS Assessment
- Ag-NGLEE Landscape Analysis - Latin America
- Ag-NGLEE Landscape Analysis – Asia
- SBCC E-Learning landscape analysis
Documents (reports, tools, statements) produced by SPRING (PMP Indicator 2.2.3)
By the end of this quarter, SPRING had completed the content for six documents including training
packages and finalized six others.
Table 11. Documents completed and finalized
TITLE OF DOCUMENT TYPE AUTHOR(S)
COMPLETED (CONTENT COMPLETED AND SUBMITTED TO USAID, IF REQUIRED)
Nigeria C-IYCF and F-IYCF Training Materials Training Materials Nigeria Country
Team
Haiti NACS/IYCF Training Materials Training Materials Haiti Country
Team
45
Table 11. Documents completed and finalized
TITLE OF DOCUMENT TYPE AUTHOR(S)
Bangladesh ENA/EHA Training Guide and Handbook for
Health Workers
Training Materials Bangladesh
Country Team
Bangladesh ENA/EHA/HFP Training Guide for Community
Workers
Training Materials Bangladesh
Country Team
MIYCN Training for Digital Green Training Materials SBCC Team
Peace Corps ENA/EHA training package Training Materials Agnes Guyon
FINALIZED (FULLY FORMATTED, GRAPHICS COMPLETED, AND POSTED ON WEBSITE, IF APPROPRIATE)
SPRING Brochure (updated) Informational Product Antonia Wolff
Bangladesh Brochure Informational Product Bangladesh
Country Team
Haiti Brochure Informational product Kristen Kappos
NCD Consultation Report Report Amanda Pomeroy
Haiti NACS Assessment Report Report Haiti Country
Team
SBCC E-Learning Landscape (desk review) [Note that
though this was completed, it is being revised and
expanded.]
Report SBCC Team
