Liberia case study - August 2019
In Libera, stunting rates increase gradually with age and peak at 42 per cent for children aged 36 – 47 months[1]. The highest increase is seen between the age of 6 – 24 months with the prevalence of stunting more than doubling from 17 to 37 percent. The 6-24-month period is critical in the development of a child as mothers introduce other foods to the child (complementary feeding). The Liberia 2018 Comprehensive Food Security and Nutrition Survey indicates that only 11 percent of children aged 6-23 months are fed the minimum acceptable diet. This indicates an urgent need for the implementation of specific interventions to support mothers and care givers to feed children appropriately during this critical period.
The focus of the Phase One of Power of Nutrition and Unicef co-investment in Liberia has been to take nutrition specific interventions to scale. Considerable progress has been made in improving the coverage of these interventions across the country following the successful integration of the services in the public health care system. The nutrition specific interventions address the immediate determinants of foetal and child nutrition and development—adequate food and nutrient intake, feeding, caregiving and parenting practices, and low burden of infectious diseases.
The 2013 Lancet recommends that in addition to nutrition-specific interventions, acceleration of progress in nutrition also requires increases large-scale, nutrition-sensitive development programmes that address key underlying determinants of nutrition—such as poverty, food insecurity, and scarcity of access to adequate care resources. This integrated approach can enhance the effectiveness and scale of nutrition-specific interventions’’.
Cognizant of the need to address stunting holistically, Unicef has been engaging other sectors in Liberia to improve the scale of nutrition-sensitive programmes in the country. One key achievement has been influencing the shift towards making the Liberia Social Safety Net (LSSN) programme nutrition sensitive. The LSSN- implemented by the Ministry of Gender, Children and Social Services (MoGCSS) with funding from the World Bank now includes a social cash transfer programme that now has nutrition objectives as one of their outcomes. To operationalise the revamped LSSN, a hand book for Nutrition – Sensitive Accompanying Measures was developed and Unicef led development of the nutrition components. In addition to regular cash transfers, beneficiary households will be provided with nutrition accompanying measures, mainly ‘soft conditions’ that aim to improve the nutrition of children and women through the promotion of home gardening and delivery of messages on appropriate child and maternal feeding practices. The conditional cash transfers and related safety nets remove the financial barriers and promote to healthcare, nutrition services and appropriate foods and nutritional commodities mainly a minimum acceptable diet.
In addition, Unicef has supported the Government to develop the Monitoring and Evaluation Hand Book of the LSSN and ensured that nutrition indicators are included in the M&E Frameworks. This will enable routine monitoring of the programme objectives and targets of the social safety net program. Two process and one outcome indicators have been included in the results framework for the LSSN as follows;
Realising Unicef’s technical expertise and comparative advantage in nutrition programming, the MoGCSS has requested Unicef to support the roll out of the nutrition accompanying measures. Unicef’s role will be to provides technical support in the design of the field implementation modalities, support the training of implementing partner and front-line community level service providers, and strengthen supportive supervision for implementation support and progress monitoring.
Unicef is engaging the to develop detailed operational modalities and implementation plans and modalities. In addition to the focus on LSSN, Unicef has commenced supporting other sectors to enhance the nutrition sensitivity of their interventions starting with the Ministry of Education to improve adolescent nutrition and Ministry of Agriculture to developed agriculture focused platform for nutrition specific actions.
Unicef
[1] Liberia Demographic Health Survey 2013
