Title

1. Title Date Implementing Baselines for Feed the Future Photo Credit: AFP

2. Session Objectives By the end of this session, You will able to: • Understand the what, why, when, and how of baseline collection • Identify which indicators require application of population-based household surveys • Successfully collect or guide contractors/implementers to collect population based data • Adaptthe standardized survey instrument to your country and program context • Apply the sampling requirements for your zone of influence at baseline, mid-term and final

3. What is a Baseline? Target • A baseline is qualitative or quantitative information that provides data at the beginning of, or just prior to, the implementation of an intervention. • Baseline information establishes where we are now relative to the outcomes we are trying to achieve. • Baselines help determine the extent to which progress is being made toward the targets. Baseline

4. Why collect baseline information? • Reveal the nature, magnitude, and severity of a situation and the size of the intervention that will be required. • Establish a starting point for key impact and outcome level indicators • Set midterm and final evaluation targets for those indicators. • Measure and describe changes in the food security of the population living in the FTF Zone of Influence (ZI) over the life of the program using comparable statistically representative data • Inform FTF future programming through lessons learnt 4

5. Methods of Collecting Data for Baselines • Primary: • Implementing partner records • Business, Farmers Association and Farm records • Interviews • Focus Groups • Observation • Censuses • Surveys of beneficiaries and stakeholders • Population Based Survey (PBS) in your Zone of Influence (ZOI) • Secondary: • National • Budget records/national accounts • Agricultural statistics • MOH records • World Bank or other donors

6. A Review of FTF Baseline Guidance using a Population-Based Survey (PBS) in the FTF Zone of Influence (ZOI)

7. Feed the Future Guidance • The source and method of collection for baseline data depends on the indicator. • For thirteen indicators, a population-based survey (PBS) in the FTF zone of influence (ZOI) is used to establish baselines. 57 Indicators 13 Indicators

8. 13 Indicators 3—1 Prevalence of underweight children under five years of age 4—1 Prevalence of poverty: Percent of people living on less than 1.25/day 4.5-1 Per capita expenditures of USG targeted beneficiaries 4.5-X Women's Empowerment in Agriculture Index (WEAI) 3—5 Prevalence of households with moderate or severe hunger 3—2 Prevalence of stunted children under five years of age 3—3 Prevalence of wasted children under five years of age 3—4 Prevalence of underweight women 3.1.9-2 Prevalence of children 6-23 months receiving a minimum acceptable diet 3.1.9-12 Women’s Dietary Diversity: Mean number of food groups consumed by women of reproductive age 3.1.9-4 Prevalence of exclusive breastfeeding of children under six months of age 3.1.9-6 Prevalence of anemia among women of reproductive age 3.1.9-9 Prevalence of anemia among children 6-59 months

9. Importance of the Zone of Influence (ZOI) • Mission’s geographic area of focus, or their zone of influence (ZOI) must be defined in clear and exact terms that delineate the geographic boundaries of the area. • Success in demonstrating results may depend on the ZOI being clearly defined • Sampling among a larger population may dilute your impact. • Missions can reduce the problem of diluted findings by choosing the smallest geo-political units that practically delineates the ZOI.

10. Considerations for Implementing the Population-Based Survey

11. Key Considerations for implementing the Population-Based Survey • International Review Board (IRB) procedures required and/or the permission required from in-country authorities to carry out the data collection work • Emphasize consent form, that participation is voluntary • Once communities have been selected, consider informing them in advance of data collection, and sometimes requesting permission is critical or required. • Ensure confidentiality. Establish procedures to protect the identity of the respondents and ensure the confidentiality of the data collected

12. Key Considerations • Local calendar/timing of collection should be considered in planning (seasonality, major holidays or religious holidays, such as Ramadan). • To ensure high quality data, double data entry is always recommended. • Sensitivity to cultural considerations. (for example, the sex of the enumerator should be considered for speaking with women and children). • Seek privacy for data collection on sensitive items. • Anemic and severely malnourished individuals should be referred to appropriate health facility

13. Ensuring survey quality • Manage the survey as an integrated project • Organize fieldwork on the basis of teams • Implement computer-assisted field edits where possible • Allow enough time for sufficient training • Establish strong supervision procedures • Check-up visits are critical – should be frequent and random • Field review of completed questionnaires • Visual observation of interviews or random re-visits • Work with fewer staff over a longer period of data collection

14. Population-Based Survey Baseline Guidance • Consistency across FTF countries in how PBS baseline information is collected is critical • To help ensure consistency, this guidance contains a standardized instrument that you should use when implementing PBS baseline, midterm and final data collection. • Consistency across survey rounds within a country is also critical

15. Adapting the population-based survey instrument • A few questions and many code lists need adaptation to the local context • Highlighted in yellow • Essential to identify local units of measure and standardized conversion rates • May wish to add modules

16. Cover Sheet and Informed Consent • Cover – unique household Identification (p.12) • Headship versus self identified primary/secondary respondents and Gendered Household Type (A08) • Determines skip patterns • Informed consent – critical (p. 13) • Each respondent must consent to be interviewed • Consent for anthropometry and anemia for each woman of reproductive age and child are embedded within those Modules. • Definition of a household and household members (p.15)

17. HH Roster and Dwelling Characteristics (p. 16, p. 18) • Used in various ways • ID code to identify respondents and targeted individuals such as women and children • Provides additional information that can be used in a Poverty Assessment Tool (PAT) for countries that are in the process of updating those

18. Poverty-related Indicator Modules

19. The Living Standards Measurement Survey (LSMS) • Measure and monitor all relevant welfare indicators (demographic, health, education, occupation, income, expenditure and consumption) • Define poverty lines and establish poverty profiles • Started in 1980s and currently supported by World Bank, UN agencies, IADB, bilaterals, governments • LSMS Web Site (www.worldbank.org/lsms) • Surveys have been done in over 40 countries

20. Poverty Assessment Tool (PAT) • Baseline data will help develop a model to estimate Per Capita Expenditure and Poverty • Working with the University of Maryland IRIS Center, FTF will develop a new or updated Poverty Assessment Tool (PAT) for each FTF country. • Techniques will estimate the relationship between easy-to-collect variables such as dwelling characteristics, education levels of household members and asset ownership; and per capita expenditures. • Once the data set is collected, one needs only to collect the proxy variables to obtain estimates of per capita expenditure and prevalence of poverty.

21. I. Household Consumption Expenditure Module (p. 27) • Collects data required to calculate total household expenditure • Different recall periods for different types of items  • Annualized to get total expenditure • Divided by # of household members from Module C to get per capita expenditure • Example: Food consumption, item by item, over a specific reference period. • The longer (more disaggregated and complete) the list of items, the higher the amount of food consumption captured. • Recall period overcomes (some) seasonality issues

22. Group exercise – 20 minutes • Without looking at the guidance, at your table, quickly list on a flip chart all of the non-food items you think a household might spend money on for 3 recall period (one week, three month, one year) • Next, list the units of measure people use to purchase food items in your zone of influence • Then, look at pages 32-41 and compare the food purchase units of measure and non-food items you listed with what’s in the guidance i

23. Group exercise – 20 minutes • Non-food items usually purchased: • Monthly • Every three months • Between four months and a year • Units of measure for food purchased weekly

24. Women’s Index Modules WEAI –Modules F, G, H, K

25. Women’s Empowerment in Agriculture Index WEAI made up of five domains: • Women’s role in household decision-making related to agricultural production • Women’s access to productive capital • Income and Expenditures • Women’s individual leadership and influence in the community • Women’s and men’s labor time allocations PILOT: being tested in Bangladesh, Uganda, Guatemala

26. Measuring Women’s Empowerment • Measuring empowerment at the individual and program level • Empowerment is relative – men as well as women • Primary and Secondary Respondent (not headship) • (i.e. male and female, male no female, female no male adults) • There are Household level (p. 20-26) and Individual level Modules (p. 43-58) • WEAI Modules Skip Patterns – Adult Male no Female Household types skip the modules

27. Group Activity – WEAI – 20 minutes • At your tables look through the WEAI (Household level p. 20-26, Individual level, p. 43-58) • Review the parts of the module you think need to be adapted to the local context in your country or will be a particular challenge (foods, cultural sensitivities, privacy) • Think of three “take away” sensitivity/privacy issues and what might be done to mitigate them, and write them on a flip chart. We’ll then post your flip charts on the wall for review.

28. Module J: Household Hunger Scale (p. 42) • HHS is common indicator used for FFP and FTF • Assesses household hunger in food insecure areas % of HH with • Little to no household hunger; • Moderate household hunger; and • Severe household hunger.

29. CAUSES Food/nutrient intake What leads to undernutrition? INTERVENTIONS • BF/CF • Diet diversity • SBCC • VA, Iron, Zinc, • Hygiene Immediate Health Water/ Sanitation health services Access to food Maternal and child-care practices Underlying causes at household/ family level • Agriculture • Poverty Reduction • Education • Health Systems Strengthening • IGA • Women’s empowerment INSTITUTIONS Basic causes at societal level POLITICAL & IDEOLOGICAL FRAMEWORK ECONOMIC STRUCTURE RESOURCES ENVIRONMENT, TECHNOLOGY, PEOPLE Revised Source: Ruel, SCN News 2008

30. How do our FTF Indicators relate to causes of undernutrition? Sustainably reduce poverty and hunger Underweight Children Improved Nutritional status especially of women and children Stunted Children Wasted Children Underweight Women Food/nutrient Health Intake Maternal and Child Care Practices Improved nutrition related behaviors Improved access to diverse and quality foods Increased resilience of vulnerable communities and households Improved use of maternal and child nutrition services Access to Food Water/ San Health Services Women’s dietary Diversity & Minimum Acceptable Diet Anemia in Women and Children Exclusive Breast feeding Household Hunger Scale

31. Module O&P--Anthropometry and Anemia Modules (p. 69-72) Anemia and Anthropometry collected together for women and children.

32. Anthropometry • Assess the nutritional status of • individuals • population groups, • used as eligibility criteria for nutrition support programs. • In Feed the Future, for Women • Use Body Mass Index (BMI) • In Feed the Future, for Children, • measurements are presented as indices, recorded as z-score including • height-for-age (HFA) • weight-for-age (WFA) • weight-for-height (WFH) • Mid Upper Arm Circumference (MUAC) also used • Not best anthropometric indicator for FTF Population based surveys=population groups

33. More information on Anthropometry FANTA-2 Bookmark showing Anthropometry in Children Anthropometry in Women • Body Mass Index (BMI) • Used in Adult Populations • Calculated as Weight(Kg)/Height(m)2 • Excludes Pregnant and women who gave birth in last 2 months

34. What and Why Anemia? • From Greek anaimia- “lack of blood” • When your blood lacks sufficient red blood cells (RBCs) • RBCs carry oxygen from your lungs to your body • Over 30% of world’s population suffer from Anemia • Pregnant women and young children are at highest risk • Most commonly due to Iron deficiency (~50%) • Iron deficiency anemia (IDA) is associated with 22 percent of maternal deaths and 24 percent of neonatal deaths. • Correcting anemia of any severity reduced the risk of death. • Other nutrient deficiencies: Vitamin A, C, B12, B6, Folate, Riboflavin, and Copper. • Physiological: blood loss, growth • Infectious diseases: Malaria, HIV/AIDS, hookworm infestation, schistosomiasis, and other infections such as TB

35. How is it assessed? • Hematocrit or Hemoglobin • For Iron Deficiency Anemia • Serum ferritin • Transferrin • TIBC More information available at: (enter DHS url)

36. Dietary Modules (p. 59 – 73) Dietary Modules L, M, N

37. Measuring Diet Across 1000 days • Low-quality, monotonous diets are the norm • the risk for micronutrient deficiencies is high • About both access and knowledge • Dietary diversity as an indicator of diet quality • Women of reproductive age are among those most likely to suffer from micronutrient deficiencies • Women’s Dietary Diversity Preconception through pregnancy: WDD • Based on Infant and Young Child Feeding (IYCF) methodology developed by WHO, Indicator Development Collaborative Process of WHO, USAID, UNICEF, IFPRI, UC Davis and FANTA • Under 6 months, Children Exclusively Breastfed • Minimal Acceptable Diet for Children 6-23 Months 6-24 months: Comple-mentaryfeeding 0-6 months: Exclusive breast-feeding See WHO For full calculation instructions http://www.who.int/child_adolescent_health/documents/9789241596664/en/index.html

38. Women’s Dietary Diversity (p. 59-60) • Focuses on food utilization/consumption at individual level • Validated International standards for collection • Uses dietary intake data from 24-hour recall • Reports Mean Number of food groups • Starchy Staples • Legumes and Nuts • Dairy • Organ Meats • Any other Meats • Eggs • Dark Green Leafy Vegetables • Vitamin A Rich Fruits and Vegetables • Other fruits and Vegetables

39. Exclusive Breastfeeding (p. 61-64) • Children under 6 months, best practice is exclusive breastfeeding • Question is based on international standards • Don’t just ask did you exclusively breast feed!

40. Minimal Acceptable Diet for Children 6-23 Months (p. 65 – 68) • Based on 24 Hour Recall • Separated by breastfeeding status • Composite indicator based on 3 components: • Minimum meal frequency • Minimum dietary diversity • Minimum number of milk feeds for non-breastfed children 42

41. Minimal Acceptable Diet for Children 6-23 Months (2) • Minimum meal frequency • Breastfed children • 2 times if 6–8 months • 3 times if 9–23 months • Non-breastfed children • 4 times for all (6–23 months) • Minimum dietary diversity •  4 food groups • Out of 7 food groups for breastfed children • Out of 6 food groups for non-breastfed (excludes dairy) • Minimum number of milk feeds for non-breastfed children •  2 milk feeds • grains, roots and tubers • legumes and nuts • vitamin-A rich fruits and vegetables • other fruits and vegetables • dairy products (milk, yogurt, cheese) • flesh foods (meat, fish, poultry and liver/organ meats) • eggs

42. Minimal Acceptable Diet for Children 6-23 Months (3) Non-breastfed children 6–23 months of age who received at least 2 milk feedings and had at least the minimum dietary diversity not including dairy and the minimum meal frequency during the previous day Breastfed children 6–23 months of age who had at least the minimum dietary diversity and the minimum meal frequency during the previous day MAD All children 6–23 months of age

43. MAD Exercise Purpose: become familiar with the MAD module, with how the questions are asked, and how the indicator is computed. Work at your tables with the exercise handout. Take 10 minutes to review the modules, and answer the questions on the exercise sheet Which MAD module question(s) Form a set with previous questions? Establish if this indicator is relevant and if questions should continue? Need to be adapted to Local context? Feed into Dietary Diversity? Feed into Minimum Feedings? Have any other purpose? Discuss how the questions that feed into minimum feedings and dietary diversity would be used to create the MAD indicator. We’ll then reconvene in plenary and spend 5 minutes addressing any questions.