Final evaluation : nutrition education and social marketing field support project (936-5113)

Evaluation covers the period 9/87-12/93 (15 months prior to the extended 3/95 PACD), with emphasis on efforts since the 1990 mid-term evaluation. The project is being implemented by the Academy for Educational Development (AED). Overall, the project has been a success. Since the mid-term evaluation, the project has strengthened, in varying degrees, the ability of public and private institutions in Mali, Burkina Faso, Niger, and Honduras to design and implement nutrition education/communication programs using a wide range of communications strategies from mass media to interpersonal exchange. TA and training targets have been far exceeded, and counterparts have generally been satisfied with the TA provided. Project monitoring and evaluation strategies have been thorough, and collaboration with PVOs, USAID Missions, and other donors has been effective. The recommendations of the mid-term evaluation have been conscientiously acted upon, especially regarding the project's need to consolidate and concentrate its efforts, undertake more innovative community-based efforts, and focus on sustainability. In particular, since the mid-term evaluation the project has devoted considerable resources to state-of-the-art syntheses and lessons learned. These include Questions and Answers on Infant Feeding, published in English, French, and Spanish and distributed worldwide; Media Promotion of Breastfeeding, a popular review of breastfeeding promotion efforts in over 25 countries; and videos on training in interpersonal communications and on solutions to micronutrient problems. Also of note are two experimental approaches to interpersonal communication developed by the project: a manual, entitled Learning to Listen to Mothers, designed to strengthen the interpersonal communications skills of nutrition and growth promotion field staff; and Healthy Communities, a new approach to rural, community-based nutrition problem assessment and counseling currently being implemented in Mali and Burkina Faso. Preliminary data reveal that project activities have had a positive effect on nutritional behaviors, and to a lesser degree, on nutritional status, and that the project merits continuation, although future activities should link more closely with P.L. 480 Title II and II programs and with other nutrition and child survival projects. Where the project has fallen short of target is more a function of unrealistic design assumptions than faulty implementation. Reducing the incidence and severity of malnutrition among young children and their mothers in a 5-year centrally funded, buy-in project is an unrealistic goal, except for possible limited demonstration purposes. Recommendations for a follow-on project are included.