Stakeholder mapping lr part 1

Nutrition Stakeholder and Action Mapping : Rwanda case study

Learning Route Workshop

Kigali October 2016

Rwanda CSA Learning Route 2016 2

Agenda

• What is nutrition stakeholder and action mapping ?

• Objectives of stakeholder and action mapping

• What the results of stakeholder and action mapping show

• What can the stakeholder and action mapping help you with ?

• Historical background of the nutrition stakeholder and action

mapping in Rwanda

• Some key analysis results and maps from both the 2012

mapping and the 2015 mapping


What is Nutrition Stakeholder and Action Mapping ?

Indicative view of :

• Who the key stakeholders in nutrition are

• Where they are working

• Delivery channels used

• Estimate of how many they are reaching

Important to know :

• It is not a research or exact science.

• Estimates of geographical and beneficiary coverage based on the info

reported and should not be used as publicly approved or validated data

• Not necessarily all stakeholders can be identified as reporting is voluntary

• Focusing on chosen Core Nutrition Actions (CNAs) and not all organizations

work on them

• Not assessing the quality of interventions

• Partners , projects and programme funding changes continuously


Objectives of Stakeholder & Action Mapping

Get better overview of who is doing what and where in nutrition in

Rwanda

Identify potential gaps in nutrition action coverage of geographies &

beneficiaries

Help inform and improve planning and scale up of core nutrition actions

in Rwanda


What the results of the Stakeholder & Action Mapping show

Overall: Shows the current situation and, by showing the

gaps, the potential for scale-up of mapped actions

Who does what,

where?

Via which

delivery

mechanisms?

How many

beneficiaries

are reached?


What can the Stakeholder & Action Mapping help you with?

For Ministries

Get a better overview

of who the partners are

and what they do

Identify potential gaps

in geographic coverage

Identify potential gaps

in action coverage

Help planning & scale-

up of nutrition actions

For Districts

See what partners are

working with food &

nutrition in your district

Get info on what

actions are being

conducted, and where

How many people are

being reached by

different actions, what

needs to be scaled up

For UN & NGOs

Enhance coordination

though better info on

what organizations are

working in the same

districts and/or on the

same actions

Identify what districts

need further support

See what actions need

to be scaled up, and

where

For Donors

Identify what districts

need further support

See what actions need

more funds to scale up

Help identify what

organizations can

cover different actions

and districts

Improve coordination among partners, and help inform

planning and scale up of nutrition actions in Rwanda


Background of the nutrition stakeholder mapping in Rwanda

• Partners were already being coordinated through the Nutrition

Technical Working Group (NTWG) that later became National

Food and Nutrition Technical working Group (NFNTWG)

• No much information was known about what they do and where

they are working

• It was not easy to prioritize interventions, allocate and track

partners

• One UN/REACH proposed to the government to conduct the

mapping as a way to support addressing these issues, and the

proposal was approved

• First mapping conducted in 2012-2013 (using 2012 data) and it

was updated in 2015 (using 2014 data)


Nutrition stakeholders and key interventions in 2012


Nutrition interventions and sector coverage in 2012


Nutrition interventions and stunting prevalence in 2012

11

Situation Analysis Dashboard (National Level) What is the nutrition situation stakeholders need to address? (2015 mapping)

Iron deficiency

Underweight

Stunting

Care

Wasting

Food security

Underweight prevalence among children 0-59 mo. old

Stunting prevalence among children 0-59 mo. old

Anemia among women 15-49 yrs old (any anemia)

Indicator Status

SAM prevalence among children 0-59 mo. old

GAM prevalence among children 0-59 mo. old

Population living under national poverty line Population living in extreme poverty (national line)

Total fertility rate Percentage with unmet need for family planning

Gender

Poverty

Nu

trit

ion

al

imp

act

37.9%

2.2%

0.6%

9.3%

19.2%

Un

derly

ing

cau

ses

Households with poor & borderline food cons. score Global Hunger Index rating

21.1% 15.6

Population

Children 6-23 mo. old with min acceptable diet (MAD) 17.8%

Education

Basic

cau

ses

Teenage pregnancy: women 15-19 with a live birth Women who participate in major household decisions Global Gender Gap ranking

44.9% 24.1%

5.5% Xx.x% 7 / 142

4.2 18.9%

Females that completed primary school or higher Literacy rate 15 years or more - Women

Xx.x% 64.7%

44.2% (2010)

2.8% (2010)

0.8% (2010)

11.4% (2010)

17.3% (2010)

21.5% (2009) 24.1 (2005)

16.8% (2010)

56.7% (2005/06) 35.8% (2005/06)

4.7% (2010) 58.7% (2010) N/A

4.6 (2010) 18.9% (2010)

30.1% (2010) 60.1% (2005/06)

Severity

N/A

N/A

N/A N/A

N/A N/A N/A

N/A N/A

N/A N/A

Source

DHS

DHS

DHS

DHS

DHS

DHS

EICV EICV

DHS DHS GGGI

DHS DHS

DHS EICV

CFSVA GHI

Year

2014/15

2014/15

2014/15

2014/15

2014/15

Health & Sanitation

Under 5 mortality rate (deaths per 1,000 live births) Low birthweight prevalence (<2,500g) Women 15-49yrs with problems accessing health care Household access to improved water source Household access to improved sanitation facilities

50 X.x% Xx.x% 74.2% 74.5%

76 (2010) 6.2% (2010) 61.4% (2010) 70.2% (2005/06) 58.5% (2005/06)

N/A N/A

N/A

DHS DHS DHS EICV EICV

2014/15 2014/15 2014/15 2010/11 2010/11

2014/15

2010/11 2010/11

2014/15 2014/15 2014

2014/15 2014/15

2014/15 2010/11

2012 2014

Infants 0–5 mo. exclusively breastfed Timely initiation of solid or semi-solid foods (6-8 mo)

87.3% 55.8%

84.9% (2010) 62.1% (2010)

N/A N/A

DHS DHS

2014/15 2014/15

Anemia among children 6-59 mo. old (any anemia) 36.5% 38.1% (2010) DHS 2014/15

Trend

Low

Medium

High

Severity:

Improvement (blue arrow)

No change (yellow arrow)

Worsening (red arrow)

Trend:

Households with handwashing facility, soap & water Xx.x%

2.1% (2010) N/A DHS

2014/15

Vit A deficiency Vitamin A deficiency among children 0-59 mo. old N/A

6.4% (1996) N/A N/A

Iodine deficiency Iodine deficiency among children 6-12 years old N/A

N/A N/A N/A N/A

Note: Missing information to be updated as soon as the full Rwanda DHS 2014/15 is released

12

What catalysts & implementers are working in which districts? How many CNAs are they working on, and how many sectors are they covering? (2015 mapping )

Nyagatare

Gatsibo

Kayonza

Karongi

Bugesera

Rusizi

Nyamasheke

Kirehe Ngoma

Rwamagana

Nyaruguru

Nyamagabe

Rulindo

Gicumbi

Huye

Nyanza

Musanze Burera

Gakenke

Ngororero

Nyabihu

Ruhango

Muhanga

Kamonyi

Gisagara

Rubavu

City of Kigali Rutsiro

City of Kigali

Kicukiro

Gasabo

Nyarugenge

Color code explanations:

Project end in 2015

Mostly central district level support

% of sectors covered:

0-25% of sectors

26-50% of sectors

51-75% of sectors

76-99% of sectors

100% of sectors

Note: The map shows all organizations that have provided mapping input, but it does not show whether they are using anyone as field implementers in the different districts.

UNICEF

CIAT

GFYA

GFYA

SFH1

WVR

UNICEF

CIAT

GHI

GC

GFYA

SFH1

WVR

ADRA

CIAT

PIH

SaCR

SFH1

WVR

HIR

UNICEF

PIH

SFH1

HIR

UNICEF

IRC

SFH1

AP

UNICEF

FAO

CIAT

SaCR

SFH1

AP2

WaterAid

WVR

HIR

GC

SaCR

WVR

UNICEF

ADRA2

AVSI

CARE

Caritas

CIAT

GC

SFH1

HIR

UNICEF

Caritas

CIAT

CRS2

GC

SFH1

UNICEF

WFP

FAO

CUR

CWR2

GC

SFH1

CUR

CIAT

CWR

CRS

GC

SFH1

WVR

AVSI

GC

SaCR

SFH1

AP

UNICEF

WFP

FAO

Caritas

CWR2

GC

SaCR

SFH1

WVR

One UN3

UNICEF3

WFP3

WHO3

FAO3

Caritas

CIAT

CWR

CRS

GC

SFH1

WRR4

WVR4

UNICEF

FAO

FHI 360

SFH1

HIR

UNICEF

FAO

SFH1

WVR2

HIR

UNICEF

FAO

AVSI

Caritas

GC

SFH1

HIR

UNICEF

WFP

FAO

Caritas

CIAT

CRS2

GC

SFH1

WVR

One UN3

UNICEF3

WFP3

WHO3

FAO3

Caritas

GC

SFH1

WRR4

WVR4

FAO

Caritas

GC

SFH1

AP

UNICEF

FAO

GC

SFH1

AP2

UNICEF

FAO

GC

SFH1

AP

HIR

1. SFH is mostly doing social marketing through local CBOs 2. Implementing partner for UNICEF EKN/GoN program 3. One UN Joint Nutrition Program (SDC funded) 4. Implementing partner for One UN SDC program

CNAs covered:

1 CNA

2-4 CNAs

5-9 CNAs

10-15 CNAs

16-23 CNAs

CIAT

GC

SFH1

HIR

UNICEF

CIAT

SaCR

SFH1

AP

UNICEF

FAO

CIAT

GHI

GC

SFH1

AP2

HIR

UNICEF

CIAT

GC

PIH

UNICEF

FAO

GC

SFH1

AP2

WVR

UNICEF

WFP

AVSI

CIAT

GC

SFH1

WVR2

UNICEF

WFP

FAO

ADRA2

AVSI

Caritas

CIAT

WVR

HIR

NB! Only shows stakeholders who have reported

13

What % of the target group is covered nationally and how? (1/2)

(2015 mapping)

Country relevant actions

# of districts

covered Key delivery mechanisms

CHWs, HFs, Women/Mother groups,

Mass campaigns, PD/H

CHWs, Health centers, UN agencies,

NGOs

CHWs, Health centers, UN agencies

CHWs, Health centers,

Mass campaigns

CHWs, Health centers, Hospitals

Health centers, Hospitals

CHWs, Health centers, PD/H,

Women/Mother groups

CHWs, Health centers, NGOs

Target groups (TG)

Pregnant & lactating women

HHs with children u5 (CBNP)

% of TG

covered

Children 6-23 months


Children 0-59 months with severe

diarrhoea

Children 0-59 months with SAM

Children 0-59 months with MAM


CHWs, HFs, Women/Mother groups,

Mass campaigns, PD/H

20 / 30

23 / 30

4 / 30

7 / 301

30 / 30

30 / 30

30 / 30

30 / 30

Promote optimal

breastfeeding practices

Provide spec. nutritious

products for CF

Promote optimal compl.

feeding practices

Provide Fe+FA supplements

Provide deworming tablets

Provide diarrhoea treatment

(w/ ORS/zinc)

Provide MNP supplements

(Ongera)

Provide treatment

of SAM

Support and provide

treatment of MAM

MIY

CN

D

isease

pre

v./m

gm

t

Mic

ron

utr

ien

t

su

pp

lem

en

tati

on

M

AM

/SA

M

Provide Vitamin A

supplements

CHWs, Health centers,

Mass campaigns 30 / 30

Conduct child growth

monitoring / screening

Promote/Provide

ANC visits (4+)

MC

H

CHWs, Health centers, Hospitals Pregnant women 30 / 30

CHWs, Health centers, Hospitals Pregnant women 30 / 30


HHs with children u5 (CBNP)

6-23 months in Ubudehe 1&2

PLW in Ubudehe 1&2


Children 5-15 years

0-25% 26-50% 51-75% 76-100%

1 / 30

30 / 30

30 / 30

1. MNP program (Ongera) is being scaled up, and is in the 2nd half of 2015 in 18 districts

30 / 30

14

What % of the target group is covered nationally and how? (2/2) (2015 mapping)

Country relevant actions

# of districts

covered Key delivery mechanisms

FFLS, Agriculture village promotors,

Coops, RAB


CHWs, Coops, NGOs

CHWs, Agriculture village promotors,

FFLS, Mass campaigns, PD/H

Pre-schools, Primary schools,

Secondary schools

Districts, UN agencies, NGOs, CHCs,

Women/mother groups

CHWs, CHCs, FFLS, Community

meetings, PD/H, Mass campaigns

VUP, Social services, FFLS,

Community leaders

Primary schools

Target groups (TG)

% of TG

covered1

Smallholder farming households

Households in Ubudehe 1 & 2

Mothers / Caregivers

Schools

Households in Ubudehe 1 & 23


CHWs, Coops, PD/H, NGOs 30 / 30

27 / 30

28 / 30

29 / 30

30 / 30

30 / 30

15 / 30

Provide materials & techn. for

small-scale horticulture

Provide animals for small-

scale husbandry

Promote food preservation

and storage

Provide input for production &

cons. of biofortified crops

Provide/Support improved

water source

Provide/Support improved

sanitation

Carry out nutr. education

(e.g. cooking demos)

Promote hygiene / hand

washing

Provide conditional social

safety net actions (VUP)

Fo

od

& A

gri

cu

ltu

re

WA

SH

2

Nu

trit

ion

ed

ucati

on

Carry out nutr. education at

school (e.g. school gardens)

Districts, UN agencies, NGOs,

Community leaders

Provide school feeding

(One Cup of Milk)

So

cia

l

secu

rity


CHWs, Coops, NGOs Household with children under 5 30 / 30

Household with children under 5

Households

Schools

Households

Schools


Schools

Primary school children

Primary schools

+8%

+3%

+5%

+4%

+1%

0%

+1%

+1%

0-25% 26-50% 51-75% 76-100%

9 / 30

21 / 30

28 / 30

5 / 30

1 / 30

4 / 30

1. Beneficiary coverage displayed as "+X%" represents the additional %-points of households reached over the last calendar year (2014). 2. Have received limited input from WASH stakeholders (who have separate technical working groups), and actual geographic and beneficiary coverage is probably higher 3. Not all Households in Ubudehe 1 & 2 are targets for the Vision Umurenge 2020 Program (aiming mostly for those without employment), so not necessarily aiming for 100% coverage here

15

Prevalence of stunting varies across districts, and not all the

districts with high stunting have all core nutrition actions (2015 mapping)

Stunting strongly prevalent in most districts,

especially in the West & South-East

All districts with 15 or more CNAs,

but only one district with all 23 CNAs

1. NB! Confidence intervals are rather large on a district level Source: Rwanda National Nutrition Screening 2014, Rwanda Stakeholder & Action Mapping 2014/15

10-14

15-19

23

20-22

# of Core Nutrition Actions

being conducted per district

Nyagatare

Gatsibo

Kayonza

Karongi

Bugesera

Rusizi

Nyamasheke

Kirehe Ngoma

Rwamagana

Nyaruguru

Nyamagabe

Rulindo

Gicumbi

Huye

Nyanza

Musanze

Burera

Gakenke

Ngororero

Nyabihu

Ruhango

Muhanga

Kamonyi

Gisagara

Rubavu


Nyagatare

Gatsibo

Kayonza

Karongi

Bugesera

Rusizi

Nyamasheke

Kirehe Ngoma

Rwamagana

Nyaruguru

Nyamagabe

Rulindo

Gicumbi

Huye

Nyanza

Musanze

Burera

Gakenke

Ngororero

Nyabihu

Ruhango

Muhanga

Kamonyi

Gisagara

Rubavu


20% - 29%

30% - 39%

>40%

Stunting prevalence among

children 0-59 months 1

<20%

16

Only one district have an action intensity where more than 75%

of core nutrition actions reach at least 30% of target population (2015 mapping)

Stunting strongly prevalent in most districts,

especially in the West & South-East

Only one district with more than 75% of actions

reaching over 30% of target population

0% - 25%

26% - 50%

76% - 100%

51% - 75%

% of actions with at least 30%2 of

target population covered

1. NB! Confidence intervals are rather large on a district level 2. 30% of target population covered or more than 1%-points additional beneficiaries covered (for Food & Agriculture and WASH infrastructure) Source: Rwanda National Nutrition Screening 2014, Rwanda Stakeholder & Action Mapping 2014/15

Nyagatare

Gatsibo

Kayonza

Karongi

Bugesera

Rusizi

Nyamasheke

Kirehe Ngoma

Rwamagana

Nyaruguru

Nyamagabe

Rulindo

Gicumbi

Huye

Nyanza

Musanze

Burera

Gakenke

Ngororero

Nyabihu

Ruhango

Muhanga

Kamonyi

Gisagara

Rubavu


Nyagatare

Gatsibo

Kayonza

Karongi

Bugesera

Rusizi

Nyamasheke

Kirehe Ngoma

Rwamagana

Nyaruguru

Nyamagabe

Rulindo

Gicumbi

Huye

Nyanza

Musanze

Burera

Gakenke

Ngororero

Nyabihu

Ruhango

Muhanga

Kamonyi

Gisagara

Rubavu


Nyamagabe is also

the only district where

all 23 core nutrition

actions are being

implemented

20% - 29%

30% - 39%

>40%

Stunting prevalence among

children 0-59 months 1

<20%

17

Action & beneficiary coverage (2015 mapping)

Some CNAs are only present

in a few districts

Beneficiary coverage for many of the

CNAs are too low

Scale up core nutrition actions to cover

more districts, sectors and villages

(e.g. by piggybacking on other programs)

Improve CNA coverage of the target

groups, while also focusing on the

quality of the action coverage

479

1521

27282829

0 10 20 30

Provide specialized nutritious products for CF Provide micronutrient suppl. (MNPs/Ongera)1

Provide/Support improved water source Provide school feeding (One Cup of Milk)

Provide/Support improved sanitation Promote food preservation and storage

Promote hygiene / hand washing Provide animals for small-scale animal husbandry Carry out nutrition education (e.g. cooking demos)

113

37

35

1618

303033

50% 0% 100%

Growth monitoring / screening Iron and folic acid

Spec. products for CF (e.g. CSB)

Nutr. education (e.g. cooking demos)

School feeding (One Cup of Milk)

MNPs (Ongera) Diarrhoea treatment (ORS/zinc)

Deworming tablets Vitamin A supplements

Social safety net actions (VUP)

ANC visits (4+) Hygiene / hand washing

Nutr. educ. school (School gardens)

Small-scale horticulture (Kitchen gardens)

Improved sanitation Food preservation & storage

Biofortified crops (beans, sweet potato) Small-scale animal husbandry

Improved water source

Treatment of SAM

Optimal BF practices Optimal CF practices

Treatment of MAM

# of districts per CNA: Beneficiary coverage per CNA:

>75%

50-75%

25-50%

<25%

+%-pts

30 districts

<30 districts

Source: Rwanda Stakeholder & Action Mapping 2014/15

Thank you

Merci beaucoup

Murakoze cyane

Government & Nonprofit

Stakeholder mapping lr part 1