Review of the efficacy and impact of emergency programmes
Donor: CIDA
Collaborators: SCUK and Westminster University
ENN Project Lead: Jeremy Shoham
Timeframe: Project completed in 2011
Background
This project was undertaken in response to the fact that there was no credible overall assessment of the impact of effectiveness of emergency Supplementary Feeding Programmes (SFPs).
Critics of emergency SFPs have raised questions about how appropriate they are in the absence of an adequate general ration and the relative cost-inefficiency of setting up a separate infrastructure from the general ration programme in order to allocate small quantities of food to vulnerable groups of people. There are also many examples of emergency SFPs that have failed to meet SPHERE targets due to problems such as difficult terrain and therefore poor access, insecurity and staffing problems. Many programmes are also not rigorously evaluated and evaluation findings are rarely published. In response to this, a research project was undertaken by the ENN, with SCUK, to evaluate data from SFPs and subsequently, carry out a literature review of the impact and effectiveness of emergency nutrition interventions.
Project Summary
This project involved two studies funded by CIDA on the efficacy and impact of emergency programmes. The first was a retrospective study (2006) and the second a literature review (2011), both of which are described below.
Retrospective Study of Emergency Supplementary Feeding Programmes, ENN and SCUK (2006)
ENN and SCUK undertook research in 2005-6 to evaluate the efficacy and effectiveness of emergency supplementary feeding programmes. The study involved an analysis of 82 programme data sets from 22 countries undertaken by 16 international humanitarian agencies between 2002 and 2005.
The key findings of the study were as follows:
- Inadequate reporting standards were being followed, so that it was difficult to assess the efficacy of programmes without considerable re-analysis of data. Furthermore, various aspects of reporting guidelines needed modification in order to improve understanding of programme performance.
- The majority of programmes (59%) were not achieving SPHERE standards in terms of outcome indicators (mortality, default, recovery, non-response, weight gain and length of stay). A major factor that undermined programme performance was defaulting.
- Impact at population level could not be demonstrated and was unlikely to be significant given low coverage levels.
The main recommendations of the study included:
- the need to define and implement minimum reporting standards .
- the need to establish a research agenda specifically to:
- assess the cost-effectiveness of alternative means of addressing mild and moderate malnutrition (e.g. expanded general rations, cash transfers, seasonal blanket supplementary feeding) compared to centre based emergency supplementary feeding
- increase understanding of the role of default in programme performance and strategies to minimise its occurrence
- increase understanding of the causes of non-response and means of addressing the problem
- explore tools for assessing impact of emergency supplementary feeding at population level, e.g. GAM:SAM ratios
- the need to establish institutional mechanisms so that data from emergency SFPs (and other types of intervention to address mild, moderate and severe malnutrition) can be collated and analysed, in order to inform development of appropriate strategies for tackling malnutrition arising from acute crises.
Literature review of peer reviewed publications showing nutritional impact of emergency nutrition programmes (2010-2011)
At the end of 2010 CIDA sanctioned the use of an under-spend to conduct a review of the peer reviewed literature into the nutritional impact of emergency nutrition programmes. This review, which was completed in July 2011, followed on from a similar earlier ENN review published in 2006 (Duffield et al 2006). As with the earlier review, it was found that there is very little published evidence on nutritional impact of emergency programmes. Most of the published studies since 2005 relate to Community Management of Acute Malnutrition programmes (CMAM). There are also a handful of studies on impact of programmes on micronutrient status. The review also found that methodological rigour of studies was in some cases flawed. The review involves re-analysis of some of the CMAM data with surprising findings about weight gain. It also draws a number of conclusions about the lack of research in emergencies and the need for institutional change if we are to increase the evidence base for nutrition programming in emergencies.
Publications
Measuring the effectiveness of supplementary feeding programmes in emergencies (2008)
More like this
FEX: ENN/SC UK investigation of impact and effectiveness of SFPs
A SFP as part of a community therapeutic care programme in Niger The ENN and Save the Children UK (SC UK) have just begun a joint research study to assess the impact and...
Defaulter and Access Study
Donor: OFDA Collaborators: CDC, ACF, Concern Worldwide, Save the Children UK ENN Project Lead: Jeremy Shoham Timeframe: Project completed in 2011 (report forthcoming)...
FEX: Minimum Reporting Package (MRP) on Supplementary Feeding Programmes
In order to evaluate the quality and impact of nutrition interventions, agencies need effective monitoring and reporting systems in place for programmes. A retrospective...
FEX: Review of Published Evidence for Impact of Emergency Feeding Programmes
Summary of unpublished paper1 The ENN have recently completed a review with funding from CIDA of the published evidence for the impact and cost-effectiveness of 6 key...
en-net: SFPs - what is wrong with them and can we fix it?
Latest after Carlos Navarro-Colorado's (et al) paper on the effectiveness of SFPs there is a tendency to turn away from them as the message seems to be misinterpreted. Do we...
FEX: Meeting on approaches to address moderate malnutrition in emergencies
The Emergency Nutrition Network (ENN) and Save the Children UK (SC UK) recently held a meeting on approaches to address moderate malnutrition in emergencies (29th-30th May...
en-net: Vacancies for Save the Children UK / ENN project supporting the introduction of the Minimum Reporting Package for SFPs
Save the Children UK and the ENN are excited to have four positions open (for nutritionists/similiar background with familiarity with SFPs) to lead and run this 18 month ECHO...
FEX: From the editor
Successful homestead gardening in Satkhira, Bangladesh The year 2013 promises to be an important year for the nutrition aid community and those whom it serves. Since...
FEX: Issue 23 Editorial
This edition of Field Exchange carries a number of articles which challenge the effectiveness of our standard responses to food and nutrition emergencies. A review undertaken...
FEX: Preparation and presentation of corn-soy blend for moderately malnourished children in Malawi
Summary of published1 and unpublished research By Beatrice Lorge Rogers (Principal Investigator), Patrick Webb (Principal Investigator), Jocelyn Boiteau (Project...
Resource: Measuring the effectiveness of supplementary feeding programmes in emergencies
This Network Paper reports on a study to determine the efficacy and effectiveness of emergency SFPs, conducted in 2005/2006 by Save the Children UK and the Emergency Nutrition...
FEX: Update on Minimum Reporting Package (MRP) trainings in London and Nairobi
By Emily Mates, Nutrition Advisor, MRP, Save the Children UK The ‘Minimum Reporting Package’ (MRP) has been developed to support standardised data collection for emergency...
Resource: A summary of the study protocol for a cash transfer intervention study in Niger
Background A review of emergency Supplementary Feeding Programmes (SFPs) was undertaken in 2005/2006, which concluded that such programmes which are targeted to already...
FEX: Treatment of moderate acute malnutrition using food products or counselling: A systematic review
View this article as a pdf By Natasha Lelijveld, Alexandra Beedle, Arghanoon Farhikhtah, Eglal E. Elrayah, Jessica Bourdaire and Nancy Aburto Natasha Lelijveld is a Teaching...
The management of acute malnutrition at scale: A review of donor and government financing
Donor: Irish Aid and CIDA ENN Project leads: Carmel Dolan and Jeremy Shoham Timeframe: Project completed in March 2013. Background Acute malnutrition is a life-threatening...
FEX: en-net highlights : LNS and implementing CMAM
Between August and October 2009, 19 questions were posted on en-net, eliciting 38 replies. A variety of issues have come up including the challenge of developing age-adjusted...
FEX: Canadian Foodgrains Bank
Name: Canadian Foodgrains Bank Annual income (expenditure) (2011/12): $44,259,143 ($39,544,210) Website: www.foodgrainsbank.ca Director(s): Governed by Board of...
FEX: WHO consultation on management of moderate malnutrition in U5s
The WHO, in collaboration with UNICEF, WFP and UNHCR, hosted a second consultation to discuss the programmatic aspects of the management of moderate malnutrition in children...
NEX: Maternal nutrition in emergencies: Summary of the state of play and key gaps
Tanya Khara and Emily Mates, ENN Available at www.ennonline.net Current evidence underlines the importance of the nutritional status of women at the time of conception,...
FEX: Maternal Nutrition in Emergencies: technical review and round table discussion
By Emily Mates and Tanya Khara Emily Mates is a Technical Director with the ENN. Tanya Khara worked as an ENN consultant on the project. Through the INSPIRE consortium, the...
Reference this page
Chloe Angood (). Review of the efficacy and impact of emergency programmes. www.ennonline.net/ourwork/reviews/impactreview
(ENN_1032)