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Concept Note – Nutrition UNDAF 2011-2015. Community-Based Programme to Reduce Maternal and Child Malnutrition . THE SITUATION. Focus of the concept note .
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Concept Note – NutritionUNDAF 2011-2015 Community-Based Programme to Reduce Maternal and Child Malnutrition
Focus of the concept note • To transform multiple, small-scale community-based initiatives into branded, government led, owned and operated community based programme. • The goal: to achieve a reduction rate of 1.3 percentage points per year for child malnutrition by 2015 – MDG
Causes and consequences • Causes: a combination of inadequacies in food, health and care. Diets that are low in quantity and quality, even when there is access to food • Over 70% of children between 6 and 24 months of age do not receive a minimum acceptable diet. • Inadequate hygiene and sanitation practices, inappropriate young child feeding practices and poor care seeking for common childhood illnesses like diarrhoea and respiratory infections • Consequences: oneof the top underlying causes of child mortality and morbidity in Cambodia • Lasting repercussions continue into adulthood, impairing both mental and physical development leading to poor performance in school and limited opportunities for work • Ultimately, it leads to adverse health, developmental and economic consequences for the individual’s entire life and can even affect the next generation.
Progress (Policy/Advocacy) • Since 2010 SPCU engaged in dialogue on improving local level service delivery in connection to cash transfer pilot • Lack of structure for community based programme found to be key barrier for MDG Joint Programme • Joint UN Concept Note drafted • DPM YimChhay Ly requested focus on sub-national capacity for local level action in 2011 meeting with UN Reps • Community based nutrition programme highlighted as a priority option at 4th NSFSN by CARD and SNEC • MoH allows community based, volunteer treatment of diarrhea and distribution of supplements
Progress (Activities) • UNCDF is providing technical & financial assistance to NCDDS for pilot testing of the following sub-national functions for local level social service delivery • Functional review and mapping by line ministries will get underway very soon, now that the subnational decree is approved (May 2012). Findings should inform this & other pilots • MDG Joint Programme achieved initial implementation of nutrition-specific activities • Success of FSN Bulletin provides platform for regular multisector monitoring • MoH commitment to expansion of Health Equity Fund provides opportunity to improve nutrition services at facility
Challenges • MDG Joint Programme not designed to achieve integrated community based programme • Fragmentation in Govt /DP – coordination and implementation / strategies and approaches. e.g. in promotion of child feeding • Concept of community based programme is now separate from cash transfer and multiple pilots emerging • All facility level nutrition activities not yet in place nationally
Future Priorities Follow up and support the implementation of the road map towards nutrition action plan – from the National Seminar • Reinforce cross-sectorial coordination and collaboration between RGC, DP and NGO • Analyze and discuss further in depth determinants of malnutrition (characteristics of HH with malnourished children) to design interventions • Develop a joint planning and investment framework (nutrition action/investment plan) to scale up evidence based nutrition interventions and ensure its financing through RGC and DP through a program based approach • Agree on key indicators and establish a multisectoral system to track progress in child and maternal nutrition • Develop a national and integrated community based nutrition program coordinated by CARD and implemented through local Government
Inmediate next steps UN/DP • Agree on a regular DP forum to discuss, plan and move forward on the concept note (e.g., DP TWG forum could be such forum) • Agree on unified steps to working with Government institutions (CARD, SNEC, NCDD, NNP, etc.) • Agree on harmonizing DP and donor initiatives on nutrition and social protection to reduce fragmentation • Agree on pursuing an umbrella structure, such as a programme-based approach, for joint funding and programme management • Agree on a evaluative framework to build in strong M&E from the start of the programme design and implementation
Resource mobilization • UNCT dialogue with individual donors should continue • Specific agencies should seek specific meetings with potential donors, such as USAID, AusAIDand others, led by the RC office? • Use Health Equity Fund to scale up facility level nutrition activities • Take concept note to full proposal in a consultative manner that is directed by CARD and takes into account the current work of NCDD and SPCU • How are the breakthrough areas concept notes being used by each agency to seek funds from other types of donors? • Donor paradigm session – resource mobilization plan by typology of donors, priority areas and agency mandates and competencies?.