Final evaluation of the community-based therapeutic care institutionalization in Malawi (CTCIM)

AID-674-A-00-10-00011. Community-Based Management of Acute Malnutrition (CMAM) implementation within Malawi began in 2002 and was supported through a series of mechanisms/projects by different donors, including the U.S. Government. USAID's most recent cooperative agreement with CWW operated from March 1, 2010-March 31, 2013 with an estimated total cost of $1,144,019. The core mandate of the CTCIM project was to scale up and institutionalize the CMAM program within the Ministry of Health (MoH) and was guided by four objectives in Malawi: (1) ensure that health service providers have the capacity to implement and manage CMAM; (2) CMAM is implemented in at least 80% of the health facilities in every district; (3) existence of a sustainable and standardized CMAM monitoring and evaluation system; and (4) evidence for support of CMAM is generated through documentation and sharing of best practices and lessons learnt and CMAM is incorporated within the Pre Service Training for Health Service providers. The CTCIM project, also known as the CMAM Advisory Services or CAS, was the next stage in a long-term collaboration between the MoH of Malawi, CWW, an Irish NGO, and USAID since 2006. There were three overarching purposes of this final performance evaluation of the USAID/Malawi Community-based Therapeutic Care Institutionalization (CTCIM) project: (1) to measure the extent to which the CTCIM project institutionalized Community-Based Management of Acute Malnutrition or (CMAM) at national and district health offices; (2) to evaluate the capacity of health providers to implement CMAM; and (3) to provide lessons learned and best practices to the Government of Malawi (GoM), USAID/Malawi, and other stakeholders on how best to scale up and institutionalize CMAM in order to combat acute malnutrition in Malawi. The evaluation questions in the scope of work for the assignment mandate an evaluation of how effectively the CMAM Advisory Services Project (CAS) institutionalized CMAM at various levels, to what extent CAS strengthened the monitoring of the CMAM program, the extent to which CMAM was incorporated into the Essential Health Package (EHP), whether stakeholders fulfilled their commitments to the CMAM National Nutritional Operational Plan, and what role gender analysis played in CMAM. (Excerpt, modified)