Mid-term performance evaluation of USAID/Nepal's suaahara II integrated nutrition program

USAID/Nepal provided five evaluation questions relating to effective coverage; multi-sectoral coordination; capacity strengthening and sustainability; monitoring, evaluation, research, and learning; and program management. The evaluation team gathered information in 7 of Suaahara’s 42 districts, central and provincial levels, conducted focus group discussions, key informant interviews and group interviews among beneficiaries and stakeholders, observed health facilities, carried out an online survey of partner non-governmental organizations, performed secondary analysis of Suaahara data, and reviewed the relevant literature. Findings indicate that scale is being achieved without losing focus on quality and program results are largely on track. Suaahara is recognized as a strong nutrition partner and has adapted well to the massive federalism shift. Suaahara staff are using data from its strong M&E system to drive program improvements. Though the targeting for gender equity and social inclusion is too broad, Suaahara has demonstrated success in reducing gaps between different socio-economic groups. Suaahara has prioritized implementing its package of interventions which represents a major part of the national multi-sectoral nutrition plan. While there is considerable progress in project implementation, sustainability efforts are not sufficiently strategic, and participating NGOs are not incorporated as long-term nutrition champions. The evaluation team recommends that Suaahara scales down operations and continues to focus in neediest areas with core plus interventions to increase reach and impact among the most marginalized; keeps capacity strengthening central to maintain gains and improve quality; rethinks approaches to improve key behaviors resistant to change; continues and re-strategizes engagement with local bodies to enhance sustainability; and engages partner NGOs beyond their current mandate. The evaluation team also recommends pro-active engagement to enhance nutrition monitoring within the national Health Management Information System; continues working with the Government of Nepal to implement the national multi-sectoral plan at local levels; and expanding linkages for homestead food production beneficiaries with markets and private input providers.