Evidence to Action: how we used data and evidence to ensure lasting change for children in Nigeria
Around the globe, malnutrition is responsible, both directly and indirectly, for 45% of all deaths among children under five. Six countries account for half of these deaths, and Nigeria is one of them.
Since 2009, a community-based approach led by the Nigerian government has reached large numbers of caregivers and young children to provide treatment for malnourished children with ready-to-use therapeutic food and basic health care. The community-based management of acute malnutrition (CMAM) brings treatment services closer to those who need it. This is made possible by making services available at decentralised treatment points using community outreach and mobilisation. Over the five-year project period and through the support provided to 428 health facilities, an estimated 269,000 children’s lives have been saved.
Regular performance assessment also revealed that the quality of the programme improved over the years. For instance, the proportion of children who were cured as a result of the treatment increased from 80% when the programme started to 92% in 2018.
CIFF’s investment in data and evidence helped our partners to refine their strategies to achieve programme objectives, informing subsequent support to ensure sustainability of these positive results. Throughout the programme, CIFF partnered with Oxford Policy Management, an international development consultancy working to enable governments to bring about lasting positive change using analytical and practical policy expertise.
Read on for an interview with Emma Jones, principal consultant at Oxford Policy Management (OPM) and project manager of the learning study to support the CMAM Phase 2 programme in Nigeria.
Tell us a bit about yourself, your background and interest in children’s nutrition. ‘I lived in rural northern Nigeria when undertaking my PhD research, and knew many families affected by child malnutrition. My nutrition sector research focuses mainly on governance, advocacy and the norms, beliefs and gender relations that affect infant and young child feeding.’
What was the aim of OPM’s involvement as a learning partner for the CMAM Nigeria programme? ‘The CMAM programme was implemented by UNICEF. OPM’s role was to support UNICEF’s ongoing process of learning and strategy refinement. Our research focused on three programme areas: promoting government commitment and financing of CMAM; CMAM information systems; and understanding the longer-term outcomes of CMAM for treated children.’
What were some of the highlights that emerged from your research? ‘In respect to promoting government commitment to CMAM, emotive engagement with key decision-makers was a game changer: such as taking political leaders to health centres to meet severely malnourished children. Pressure from civil society and the media were also important.
Our analysis of CMAM information systems indicated challenges with data collection and recording at health facility level; this reduces the accuracy of CMAM performance data such as information related to children who miss treatment sessions and those who successfully recover.’
What has been the impact of the studies led by OPM – have they influenced any key decision makers? ‘OPM’s analysis helped UNICEF to refine its engagement strategy. In some states, this contributed to the release of public funds for CMAM. CIFF also responded to the research by setting up a separate civil society project in Nigeria. Our analysis of CMAM information systems has generated debate within the CMAM programme and among other nutrition partners on how to improve data systems.’
Were there any unique features to this research that contributed to its success, in terms of take-up of the evidence it generated? ‘We worked closely with UNICEF and key civil servants in the focal states. UNICEF engaged in the design and interpretation of the findings, as well as participating in some of the interviews. This strengthened the relevance of the research and uptake of the findings.’
What’s next for your research dissemination activities? Any key events/conferences we should look out for? ‘We are writing up the findings for the wider nutrition community and hope to publish them in journals later this year. There will also be Nigeria events and online dissemination of the findings concerning the longer-term outcomes of CMAM.’
Do you have any feedback for CIFF on how we have worked together? We really appreciated CIFF’s flexibility and responsiveness to the findings. The monthly calls with CIFF and UNICEF were also great for timely sharing and decision making.
The Community Management of Acute Malnutrition in Nigeria programme was supported by CIFF from 2009 to 2018, implemented by the Government of Nigeria and UNICEF, and saved an estimated 269,000 lives.
For more information, have a look at the grant page, or watch a short video on the programme here.
For more info about CIFF’s approach to evaluation please see: https://ciff.org/about-us/data-and-evidence/
To find out more at OPM, see here: https://www.opml.co.uk/
UNICEF, 2018: https://www.unicef.org/nigeria/nutrition
UNICEF Final Progress Report to CIFF, August 2019