Accelerating Healthy Agriculture and Nutrition (AHAN) End-line Evaluation (Executive Summary)
Project description
In the Lao People’s Democratic Republic approximately one in three children are stunted throughout the country (33%), while one in five are underweight (21%), and one in ten are wasted (10%), according to the 2017 Lao Social Indicator Survey II. The direct causes of undernutrition is the lack of adequate nutrient intake and the effects of food, and water-borne and infectious diseases, with underlying causes including lack of access to adequate food, in terms of both quality and quantity, poor access to health care, and poor environmental hygiene. Due to the intersecting causes of undernutrition, the National Nutrition Strategy and Plan of Action identified 22 priority actions within overall management, health, agriculture and education. The newly confirmed National Plan of Action for Nutrition (2021 to 2025), also identified associated sector action plans involving gender and industry and commerce which have an impact on women and children’s nutrition.
The project, led by World Vision, has been implemented by a consortium of partners including Agronomes et Vétérinaires Sans Frontières (AVSF), Green Community Development Association (GCDA) and the Burnet Institute (BI). Implementation targets 12 districts across 3 southern provinces, supporting 10 villages per district:
- Savannakhet province: Phine, Sepone, Thapanthong, Phalanxay, Atsaphone and Xonnabouly district;
- Saravane province: Saravane, Ta Oi, Toomlarn and Lao Ngarm district and
- Attapeu province: Xaysetha and Samakkhixay district.
Specific Objectives
The Accelerating Healthy Agriculture and Nutrition Project (AHAN) has a five-year European Union (EU) funding for AHAN project (1st October 2017 to 30th September 2022) under the EU program “Partnership for Improved Nutrition in Lao PDR – Pillar 3. The project included matching component from the Australian government through the Australian NGO Cooperation Program (ANCP). The AHAN project aimed to enable households to effectively reduce the prevalence of stunting and underweight in children under five through these outcomes:
- Improve access to and availability of sufficient and/or diverse foods year- round
- Improve dietary and care practices among women of reproductive age (15-49 years) and children under 5 years
- Reduce incidence of selected Water, Sanitation and Hygiene (WASH) related diseases/illnesses linked to undernutrition
- Improve gender equitable relations at the household level, particularly in decision-making and distribution of workload
- Strengthen multi- sector coordination and support for nutrition
The purpose of the Endline Evaluation is to assess the level of impact in line with project design and implementation from 2019-2022, by assessing the level of achievements made against the goal, outcome, and output level objectives, and to examine the key achievements, successes across the phases (changes in baseline vs endline results, implementation, monitoring and transition/exit processes) and lessons. On this basis, the evaluation has suggested possible remedies and recommendations to the Lao Government through the Ministry of Health, Ministry of Agriculture and Forestry and the Lao Women’s Union for consideration to ensure ownership and sustainability of the gains the project has made.
The evaluation used a mix of qualitative and quantitative methods with key informant interviews of key stakeholders and focus group discussions with different groups of project beneficiaries to examine the factors for successes, and the challenges faced by the project. Household data was generated using a quantitative survey technique, including anthropometric measurements of children under two years and under five years, to allow for comparative analysis with baseline values. A total of 1,240 households participated in the quantitative survey, in villages randomly selected from the twelve districts.
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