1. USAID/Tufts University Food Aid Quality Review Programming: Results and Recommendations IFADC Kansas City June 28, 2011

2. Goals Describe and assess current uses of FBFs Review evidence of effectiveness and challenges in programming –Focus on effectiveness for explicit nutritional goals –Programming is as important as product mix and composition Recommendations for uses, and new products in the evolving context of Title II programming

3. Data Sources USAID Title II Program documents –MYAPs, SYAPs, Program Evaluations, PREPS, Results Reports –Program guidance from USAID, WFP (Country Guidance, Food Aid and Food Security Assessment (FAFSA), Bellmon Analyses (BEST), TRM, CRG) Published and unpublished literature Survey of Agencies Implementing Title II programs Qualitative interviews with senior officials and other key informants USAID and USDA officials

4. Results

5. Implementing Partner Survey Uses of CSB Main use is in MCHN and HIV+/TB programming Used in general family rations –To enhance nutritional quality Used as incentive or pay in FFW/FFT

6. Implementing Partner Survey: Ration Size Ration sizes vary widely by beneficiary type and by technical sector Basis for ration size is variable –expect sharing; –calculate as residual in CRG Suggests fine-tuning of micronutrient composition must be balanced against the need for wide tolerances

9. Preparation of FBFs (survey data) Of programs using CSB –76% instruct participants to prepare with another food –Of these, 29% are told to prepare it with oil –18% with sugar –About 2/3 with ‘regular family food’ Almost 100% of programs providing CSB that also provide fortified vegetable oil

10. Programming Guidance Increasing level of technical assistance in program design –Food security analyses –BEST analyses Increasingly prescriptive (viz. PM2A) Emphasis on evidence base Shifting priorities (nutrition, agriculture) Guidance at times inconsistent and out of date, and issued late; proliferation of documents

11. Recommendations

12. Match “product to purpose”: use nutritionally enhanced products for nutritional goals Recommendations

13. Match Product to Purpose Improve micronutrient profile of CSB and oil Target CSB for health and nutritional purposes only Provide CSB with oil –Implies need for bcc Use enhanced cereals, not a different CSB to improve quality of general ration Recommendations

14. Strengthen evidence base for innovations in products, programming approaches, and institutional processes Recommendations

15. Strengthen Evidence Base Increase evidence base for programming –Experiment with approaches to bcc –Experiment with packaging to affect use, sharing Incorporate sustainability concerns Incorporate cost-effectiveness –Not cost per ton or per ‘mouth’ but cost per effect achieved Recommendations

16. Strengthen Evidence Base Seek input from end users: Increase input from the field Program design should incorporate local knowledge and experience Support implementing partners to incorporate local data into the design of rations and programs Recommendations

17. Strengthen Evidence Base Conduct rigorous field-based studies: Sharing Assumptions about self targeting Use of any new commodities Assessment and monitoring is needed in field settings at scale USAID should improve training on needs assessment and on monitoring and evaluation methods Recommendations

18. Provide clear programming guidance, including improved decision tree tools Recommendations

19. Improve Guidance Update and harmonize operational guidance Invest in new behavior change communication Issue programming guidance six months before proposals are due Facilitate field-initiated program and product innovations Incorporate sustainability concerns Incorporate cost-effectiveness –Not cost per ton or per ‘mouth’ but cost per effect achieved Recommendations

20. Enhanced guidance should be prepared (such as decision tree tools) to enable agencies to better select commodities for programming. Implement flexibly: constraints and local contexts differ Emergency programs may face different constraints  Need to meet needs of an entire population  Often very limited access to food  Often higher incidence of severe malnutrition Recommendations Improve Guidance

21. INSERT FLOW CHART AND DECISION TREE HERE? Decision Tree Example

22. Thank you