Liberia Multi-Sectoral Nutrition Costed Strategic Plan (LMNCSP)

1 Liberia Multi-Sectoral Nutrition Costed Strategic Plan (LMNCSP) 2024-2028 ii TABLE OF CONTENTS TABLE OF CONTENTS ................................................................................................................1 LIST OF TABLES ........................................................................................................................ i LIST OF FIGURES ....................................................................................................................... i LIST OF ABBREVIATIONS AND ACRONYMS ........................................................................... ii STATEMENT FROM THE VICE PRESIDENT OF LIBERIA ............................................................v FOREWORD ..........................................................................................................................v 1 CONTEXT ....................................................................................................................... 12 1.1 Malnutrition: Global, Regional, National Health and Socioeconomic Issues ..... 13 1.1.1 Global Context ............................................................................................................. 14 1.1.2 African Region Context ............................................................................................... 15 1.1.3 West AfricanRegion Context ...................................................................................... 15 1.1.4 Country Context .......................................................................................................... 16 1.1.5 Socioeconomic Status ................................................................................................ 17 1.1.6 Education and Literacy ............................................................................................... 18 1.1.7 Access to Basic Health Services ................................................................................ 18 2 LIBERIA NUTRITION SITUATION ANALYSIS .....................................................................19 2.1 Introduction ................................................................................................................. 19 2.1.1 Trends of malnutrition in Liberia .............................................................................. 19 2.1.2 Trend ofWasting .......................................................................................................... 21 2.1.4 Trends of Micronutrient Deficiencies ....................................................................... 22 2.2 Causes of Malnutrition and Interventions ............................................................... 26 2.2.5 Human Resource for Nutrition ................................................................................. 27 2.2.7 Gender Mainstreaming in the LMNCSP ................................................................... 28 3 MULTI-SECTORAL STRATEGY DESIGN FRAMEWORK .......................................................29 3.1 Introduction: ................................................................................................................ 29 3.2 Interventions in Key Sectors ...................................................................................... 29 3.3 Multi-Sector Nutrition Governance .......................................................................... 29 3.4 Nutrition-Specific Interventions ............................................................................... 35 3.5 Nutrition-Sensitive Interventions ............................................................................. 35 3.6 Nutrition Governance ................................................................................................. 36 3.7 National Policy and Legal Framework forthe LMNCSP .......................................... 36 3.8 Nutrition a Universal Human Right ......................................................................... 36 4 VISION, MISSION, GOAL, OBJECTIVES and STRATEGIES .................................................41 4.1 Vision ............................................................................................................................ 42 4.2 Mission ......................................................................................................................... 42 4.3 Goal ............................................................................................................................... 42 4.4 Objectives ..................................................................................................................... 43 4.5 Purpose of the Multi-sectoral NutritionCosted Strategic Plan ............................. 43 4.6 Target Audience of the Multi-sectoral NutritionStrategy ...................................... 43 5 STRATEGIC OBJECTIVES, STRATEGIES and INTERVENTIONS ...........................................45 5.1 Rationale ...................................................................................................................... 46 iii 5.2 Theory of Change and Logical Framework .............................................................. 48 5.3 Key Strategic Objectives and Strategies................................................................... 49 5.4 Strategies and Priorities for High Impact Interventions ........................................ 53 6 MONITORING,EVALUATION,ACCOUNTABILITY, AND LEARNING (MEAL) FRAMEWORK ......................................................................................................................71 6.1 Introduction ................................................................................................................. 72 6.2 Purpose of the Monitoring, Evaluation, Accountability and Learning (MEAL) Plan .................................................................................................. 73 6.3 Monitoring Processes .............................................................................................7397 6.4 Data Generation .......................................................................................................... 73 6.5 Data Validation ............................................................................................................ 73 6.6 Data Analysis ............................................................................................................... 73 6.7 Information Dissemination ........................................................................................ 73 6.8 Stakeholders Collaboration ....................................................................................... 74 6.8.1 Accountability Frameworks ....................................................................................... 74 6.9 Evaluation of the Process and Criteria ..................................................................... 74 7 RESOURCE REQUIREMENTS ..............................................................................................77 7.1 Resource requirements for the Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP) ............................................................................... 78 7.2 Summary cost estimates for the Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP) . ............................................................ 78 8 INSTITUTIONAL FRAMEWORK ..........................................................................................85 8.1 Roles and Responsibilities of the Main Nutrition Stakeholders ........................... 87 A. Ministry of Education (MoE) ............................................................................. 89 B. The Ministry of Commerce and Industry (MoCI)........................................... 89 C. The Ministry of Health (MoH) .......................................................................... 89 D. Nutrition Division of MoH ................................................................................ 89 E. Ministry of Agriculture (MoA) ........................................................................... 90 F. National Fisheries and Aquaculture Authority (NaFAA) ............................... 90 G. National Water, Sanitation and Hygiene Commission (NWASHC) ............. 90 H. Ministry of Internal Affairs (MIA) ..................................................................... 91 I. Ministry of Finance and Development Planning (MFDP) .............................. 91 J. Ministry of Information, Cultural Affairs and Tourism (MICAT) ................... 91 K. Ministry of Public Works (MPW) ...................................................................... 91 L. SUN Civil Society Alliance of Liberia (SUN CSAL) ........................................... 91 8.2 Risks and Assumptions (National, County and District Levels) ............................ 92 8.2.1 Risks .............................................................................................................................. 92 8.2.2 Assumptions ................................................................................................................ 92 9 REFERENCES .......................................................................................................................96 10 STRATEGIC PLAN ANNEXES ...............................................................................................97 ANNEX A: Monitoring and Evaluation Matrix ................................................................................ 97 ANNEX B: Implementation Matrix ........ ........................................................................................112 iv LIST OF TABLES Table 1: Summary of Strategic Objectives and Strategies . . . . . . . . . . . . . . . . . . . . . . . . . 50 Table 2: LMNCSP Resource needs per Line Ministry & Agencies in USD Millions . . . . . 80 LIST OF FIGURES Figure 1: Trend of under-5s stunting & wasting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Figure 2: Under-5s stunting rates by county . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Figure 3: Under-5s wasting prevalence by county . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Figure 4: Prevalence of anemia in WRA (2000-2020). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Figure 5: Trends of thinness, overweight & obesity in children & adolescents . . . . . . . . 25 Figure 6: Exclusive breastfeeding practices across Liberia . . . . . . . . . . . . . . . . . . . . . . . . . 26 Figure 7: Infant & Young Child Feeding Practices (IYCFP) . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Figure 8: The Conceptual Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Figure 9: Theory of Change (ToC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Figure 10: The LMNCSP strategic objectives (SOs). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Figure 11: Monitoring processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Figure 12: 5-Year cost summary by Strategic Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Figure 13: Percentage per intervention cost by strategic objectives . . . . . . . . . . . . . . . . . . 79 Figure 14: Annual Breakdown of Cost the LMNCSP SOs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Figure 15: Cost of Key Priority Areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Figure 16: LMNCSP strategy resource needs per Line Ministry & Agencies in USD Millions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Figure 17: Liberia Nutrition Institutional Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 v High-level meeting with the Vice President of Liberia and nutrition stakeholders to build consensus of the Nutrition Costed Plan Mother practicing exclusive breastfeeding in Liberia. vi LIST OF ABBREVIATIONS AND ACRONYMS ACF Action Against Hunger ACSM Advocacy Communication and Social Mobilization ALRI Acute Lower Respiratory Infection ANC Antenatal Care BCC Behaviour Change Communication BFCI Baby Friendly Community Initiatives BFHI Baby Friendly Hospital Initiatives BMI Body Mass Index BMS Breast Milk Substitutes CAN Compendium of Actions for Nutrition CBO Community Based Organization CFSNS Comprehensive Food Security and Nutrition Survey CMBS Code of Marketing of Breastmilk Substitute CRC Convention on Rights of Child CSO Civil Society Organization CU5 Children under 5 years CHT Community Health Team DHT District Health Team DNIs Direct Nutrition Interventions DQA Data Quality Assessment EBF Exclusive Breastfeeding ECE Early Child Education ENAs Essential Nutrition and Actions EPA Environment Protection Agency EVD Ebola Virus Disease FAO Food and Agriculture Organization of the United Nations FBO Faith Based Organization FANTA Food and Nutrition Technical Assistance GAM Global Acute Malnutrition GDP Gross Domestic Product GMF Genetically Modified Food GNR Global Nutrition Report GoL Government of Liberia HFS Health Facility Survey HINI High Impact Nutrition Intervention HIV / AIDS Human Immune Virus / Acquire Immuno Deficiency Syndrome HMIS Health Management Information System IEC Information, Education Communication IFA Iron Folic Acid IMAM Integrated Management of Acute Malnutrition IMCI Integrated Management of Childhood Illnesses INGOs International Non Governmental Organizations IPC Integrated Food Security Phase Classification ITNs Insecticide-Treated Nets IYCF Infant and Young Child Feeding JMP Joint Monitoring Program KAP Knowledge, Attitude and Practice KPC Knowledge, Practice and Coverage LDHS Liberia Demographic and Health Survey LISGIS Liberia Institute of Statistics & Geo-Information Services M&E Monitoring and Evaluation MAM Moderate Acute Malnutrition MFDP Ministry of Finance and Development Planning MAIYCN Maternal, Adolescent, Infant and Young Child Nutrition MNP Micro-nutrient Powder MoGCSP Ministry of Gender, Children and Social Protection MICAT Ministry of Information, Cultural Affairs and Tourism MoA Ministry of Agriculture MoCI Ministry of Commerce and Industry MoE Ministry of Education MoH Ministry of Health MPW Ministry of Public Works MoU Memorandum of Understanding MSP Multi-Stakeholders Platform MoYS Ministry of Youth and Sports vii NaFAA National Fisheries and Aquaculture Authority NCC National Consumer Commission NCDIs Non-Communicable Disease and Injury NGOs Non-Government Organizations NHP National Health Policy LMNCSP Liberia Multi- Sectoral Nutrition Costed Strategic Plan NPHIL National Public Health Institute of Liberia NNP National Nutrition Policy NWASHC National Water Sanitation and Hygiene Commission ODF Open Defecation free PAPD Pro-Poor Agenda for Prosperity and Development PHC Primary Health Care PIH Partners in Health PHM Post-Harvest Management PLW Pregnant and Lactating Women PLWHA People Living with HIV / AIDs PPP Public-Private Partnership PRSP Poverty Reduction Strategic Paper REACH Renewed Efforts Against Child Hunger and Undernutrition SAM Severe Acute Malnutrition SBCC Social and Behaviour Change Communication SDG Sustainable Development Goals SHN School Health & Nutrition SMART Standardized Monitoring and Assessment of Relief and Transition SOP Standard Operating Procedure SUN Scaling Up Nutrition SWOT Strength Weakness Opportunity Threat ToTs Trainer of Trainers TWG Technical Working Group UNFPA United Nations Populations Fund UNDP United Nations Development Programme UNEP United Nations Environment Programme UNICEF United Nations Children’s Fund USAID United States Agency for International Development USD United States Dollar WAHO West African Health Organization WASH Water Supply Sanitation and Hygiene WBW World Breastfeeding Week WFP United Nations World Food Programme WHA World Health Assembly WHO World Health Organization WIFA Weekly Iron Folic Acid (supplementation) WRA Women of Reproductive Age viii STATEMENT FROM THE VICE PRESIDENT OF LIBERIA FOREWORD The Government of Liberia (GoL) recognizes the importance of optimal nutrition and the essential contribution it makes towards national development, specifically human capital, economic growth, and consequentially work productivity. Nutrition is fundamental to the socio-economic growth and development of Liberia; thus, the Government has placed nutrition high on the national development agenda. The Government of Liberia National Agenda, The Pro-Poor Agenda for Prosperity and Development (PAPD), Pillar 1 emphasizes the reduction of stunting to 22 percent by 2023. Malnutrition rates in Liberia among children under-five years are very high with 14 out of 15 counties having stunting rates over 30 percent. Three percent of children under-five are classified with acute wasting while 11 percent are underweight, and an increasing double burden of overweight of 4 percent of children and 16 percent of women of reproductive age. Anemia is also affecting 71 percent of children, 55 percent of adolescents and 52 percent of pregnant women.Liberia has made some progress in stunting reduction from 45 percent to 30 percent between 2000 and 2020 and further down to 29.8 percent in 2022 (UNICEF, 2018) and 55.2 percent practicing Exclusive Breastfeeding (GNR 2022). The GoL recognizes that nutrition is multi-faceted, so it requires a multi-sectoral approach. In this view, the development of the five-year Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP) process commenced following the revision of the National Nutrition Policy (NNP, 2019 2024) in 2019. The LMNCSP has five Strategic Objectives listed in the revised National Nutrition Policy (NNP) 2019 – 2024 that define the scope of the LMNCSP. Additionally, the Comprehensive Food Security and Nutrition Survey (CFSNS) 2018, and Liberia Nutrition Situation Analysis 2019 have adequately presented the multiple immediate causes and underlying factors responsible for the current nutrition situation in Liberia. The GoL encourages each sector to fulfill its mandate. I therefore call upon all line ministries and stakeholders to join hands in the successful implementation of the five-year Liberia Multi-Sector Nutrition Costed Strategic Plan. Chief Dr. Jewel Howard-Taylor Vice President of the Republic of Liberia ix ACKNOWLEDGEMENT The Ministry of Health (MoH) appreciates all the institutions and individuals who contributed their valuable technical and financial support to the development of the Liberia Multi-Sectoral Nutrition Costed Strategic Plan (LMNSCP). These include the West Africa Health Organization (WAHO), United Nations Children’s Fund (UNICEF), United Nations World Food Programme (WFP), Food and Agriculture Organization of the United Nations (FAO), United Nations Population Fund (UNFPA) and the Government of Ireland via Irish Aid, World Health Organization (WHO), Last Mile Health, Welthungerhilfe, WaterAid, Action Against Hunger, Concern Worldwide, the Technical Working Group which comprised of representatives from relevant line ministries, development partners, the SUN Secretariat, SUN Civil Society Alliance of Liberia, Education, Health, Gender and Social Protection, Commerce and Industry, Public Works, Finance and Development Planning, National Fisheries and Aquaculture Authority, Information Cultural Affairs and Tourism, National Water, Sanitation and Hygiene Commission, National Public Health Institute of Liberia, Nutrition Division of the Ministry of Health, the Monitoring and Evaluation Department and Policy Unit of the Ministry of Health. It acknowledges the coordination and technical support of these outstanding individuals – the former SUN Movement Focal Person Mrs. Mameni Linga-Morlai, the National Coordinator of the SUN Movement of Liberia, Mr. Augstine Musah, United Nations REACH – Mrs. Kou Baawo, the Nutrition Director – Dr. Annette Brima-Davis, UNICEF Nutrition Specialist – Dr. Jecinter Akinyi Oketch, Mr. Linus N. Sarkor, Sr, Dr. Daniel N. Mwai the national and international consultants respectively. Wilhemina S. Jallah, MD, MPH, CHES, FLCP, FWACP Minister Ministry of Health x 11 CONTEXT 1 12 The Government of Liberia (GoL) recognizes the importance of optimal nutrition and the essential contribution it makes towards national development, specifically human capital, and economic growth. This is in line with global evidence which shows that investing in nutrition is indeed cost effective and can yield human capital gains including reducing child deaths by more than one third per year, improving future earning potential by 5 to 50 percent, improving school attainment by at least one year, reducing poverty (well-nourished children are 33 percent more likely to escape poverty as adults), and boosting gross national product by 11 percent. Studies have also shown that every1 United States dollar invested in nutrition can yield up to 16 U.S. dollars in return. The Government of Liberia National Agenda, The Pro-Poor Agenda for Prosperity and Development (PAPD), Pillar 1 emphasizes the importance of reducing all forms of malnutrition and place priority on reduction of stunting among children under five years. Liberia has made some progress in stunting reduction from 45 percent to 30 percent between 2000 and 2020 and now 29.8 percent in 2022(UNICEF, 2018); (GNR, 2022). This progress puts Liberia amongst 50 countries globally which are on track to meet the World Health Assembly (WHA) 2025 targets of 40 percent reduction (WHO, 2020)for stunting prevalence among children under- five years old, which is 18 percent stunting prevalence rate for Liberia. However, stunting continues to affect around one-third of children under five years (265,000 children). In the worst affected counties, Rivercess, stunting is at 41 percent, Bong 37.4 percent which is over 7 percent higher than the national average. Even in the least affected area (Greater Monrovia), stunting is still 20.7 percent. These data mean that the stunting level in Liberia is classified as “very high” based on the World Health Organization (WHO) thresholds. Other forms of malnutrition of great concern include wasting, underweight, anemia, micronutrients deficiency, and overweight among children under-5 years, adolescents, pregnant and lactating women in country. Ensuring that the nutritional status of the general population improves is a human rights requirement of the Government of Liberia. Health and Nutrition are the fundamental rights of children as indicated in the Universal Declaration of Human Right, 1948,1 as ascribed in the Article 25 setting the right to food, medical care, and basic social services as the requirements for the wellbeing and health of every individual and family. The WHO, The United Nations Convention on the Rights of the Child, the African Charter on the Rights and Welfare of the Child2. The Children’s Law of Liberia in 2011, the UN Sustainable Development Goals 2, 3, 4,5, & 6, are major national and international instruments supportive of nutrition for Liberians. The LMNCSP has 5 Strategic Objectives which are aligned with the 12 Priority Areas outlined in the revised National Nutrition Policy (NNP) 2019 – 2024 that define the scope of the LMNCSP. 1 https://www.un.org/en/universal-declaration-human-rights 2 https://www.unicef.org.uk/what-we-do/un-convention-child-rights 1 13 The NNP revised in 2019, Comprehensive Food Security and Nutrition Survey (CFSNS, 2018), and Liberia Nutrition Situation Analysis 2019 have adequately presented the multiple immediate causes and underlying factors responsible for the current nutrition situation in Liberia. The LMNCSP acknowledges the central role of the Food Systems – working together with health, water, hygiene and sanitation, education, and social protection systems – to provide nutritious, safe, affordable, and sustainable diets for children, adolescents, and women, while ensuring adequate nutrition services and positive nutrition practices across the life cycle. The process for developing the LMNCSP entailed the broad participations of relevant multi sectoral stakeholders (Government, counterparts, Civil Society Organization, Scaling up Nutrition (SUN), United Nations agencies, donors, and development partners and scientific evidence review including the Compendium of Actions for Nutrition (CAN) for each sector. The process for developing this plan has been led by the Nutrition Division of the Ministry of Health and coordinated by the SUN Secretariat-Liberia, with the support of other key stakeholders. This collaborative approach will enhance information collection and dissemination; harmonize efforts and nutrition awareness amongst decision makers. It will also positively shape the enabling environment for nutrition sensitive policies, guidelines, law, legislation, and implementation. This multi-sectoral approach requires competent and adequate human, financial and infrastructure resources. 1.1 Malnutrition: Global, Regional, National Health and Socioeconomic Issues 1.1.1 Global Context Globally, 45 percent of death in children under five years is related to malnutrition, amounting to 3 million deaths among children per year3 . The global burden of malnutrition is unacceptably high, affecting every country in the world, making malnutrition a global issue. The gains made over the years are not sufficient and there is still a lot to be done. According to the WHO, malnutrition in all its forms includes undernutrition (wasting, stunting, and underweight), inadequate vitamins or minerals uptake, overweight, obesity, and diet related non-communicable diseases. As of 2022, the global nutrition situation was as below: More than 1 billion people worldwide were said to be overweight according to WHO 2022. This amounts to 650 million adults who are obese, 340 adolescents and 39 million children million. This number may reach 167 million by 20254 while 462 million adults were underweight. Forty five (45) million children under five years of age were wasted, 17 million were severely wasted and 149 million were stunted. 3 Black et all, 2013 4 https://www.WHO.int/news/world obesity day- 2022 14 Around 45 percent of deaths among children under five years of age are linked to undernutrition. These mostly occur in low- and middle-income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising. The developmental, economic, social, and medical impacts of the global burden of malnutrition are serious and lasting, for individuals and their families, for communities and for countries.5 Malnutrition increases health care cost, lowers productivity, slows down economic growth, and perpetuates a cycle of poverty and ill health.6 A third of women at reproductive age in the world are anaemic while 37 percent of the world’s adult are overweight or obese and each year approximately 20 million babies are born underweight. One in four children under-5 years worldwide are stunted although some progress has been made. The overall gains in stunting between 2000 to 2018, global stunting prevalence have decreased from 32 percent to 21.9 percent resulting to a reduction in the number of children who are stunted from 198.2 million to 149.0 million. This means 6.7 percent of the world’s children population are at risk of death or will not reach their full potentials in life.7 1.1.2 African Region Context Africa’s child population will reach 1 billion by 2055, making it the largest child population among all continents. According to the 2022 Global Nutrition Report, Africa faces serious nutrition-related challenges, stemming from both a deficiency in nutrients and obesity. Despite a decrease in the prevalence of stunting globally, about 60 million African children under-5 years are not growing properly. Two in five children in Africa are stunted. At least 10 million others are also classified as overweight, posing both severe health burden on countries and hampering broader development efforts.8 Anemia affects 40.4 percent of women at reproductive age, 13.7 percent of children are born with low weight at birth, exclusive breast feeding for 0-5 months infants is 44 percent which is higher than global rates of 43.8 percent, overweight is 5.3 percent among children under five years; the second lowest among all regions. Stunting is 30.7 percent, highest than global rates of 22.0 percent and wasting 6.0 percent which is lower than global average of 6.7 percent.9 1.1.3 West African Region Context The West African Region comprises of 18 countries (Benin, Burkina Faso, Ivory Coast, Cape Verde, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Sou Tome and Principe, Senegal, Sierra Leone, Saint Helena, Togo). West Africa has a population of close to 372 million, of which 62.3 million are children under five years of age (CU5). Over one third of these 19 million CU5 are stunted, while the prevalence of CU5 wasting and overweight 5 https://www.who.int/news-room/fact-sheets/detail/malnutrition (site visited on 8/9/2023) 6 https://www.who.int 7 https://www.unicef.org 8 https://qz.com>africa 9 globalnutritionreport.org (visited 8/9/2023) 15 is 9 percent and 2 percent respectively (GNR, 2017). Overweight and obesity also affect the adult population, with 14 percent and 37 percent of women affected respectively (GNR, 2017). Nearly half of the women of reproductive age 49 percent have anemia and 47 percent of children aged 6-59 months have vitamin A deficiency (WAHO, 2017). In October 2017, 100 persons from the West African countries came together and debated the West Africa Health Organization's (WAHO) regional nutrition strategic plan (Regional Nutrition Strategy for West Africa, 2018-22), which overall objective is to scale up nutrition-specific and nutrition-sensitive activities base on the strategic objectives costing USD$41.3 Million: (1) To improve governance, coordination; implementation, planning, and monitoring and evaluation of food and nutrition security; (2) To consolidate knowledge management, including sharing of best practices, monitoring for optimum decision-making; (3) To consolidate capacities for regulation and implementation of high-impact interventions in nutrition; and (4) To mobilize resources for food and nutrition security. The WAHO stresses the need for countries in the region to support financially and have strong political will for the full implementation of these interventions, based on sound monitoring, budget controls and information and data collection on progress made in a transparent manner. 1.1.4 Country Context Liberia is located on West Coast of Africa with a population of 5.2million persons as of 2022 (LIGIS 2022)10 and life expectancy of 61 years as of 2021.11 Liberia birth rate has increase by 2.56 percent which is almost double the world average growth rate. The capital, Monrovia, hosts 25 percent of its population. Liberia covers a land space of 43,000 square miles; females make up 49.5 percent of the Liberian population according to World Population Review, 2019. 12 About 70 percent of the population was below the age of 35 and 44.5 percent of the population were below the age of 15 years. Twenty-three percent of its population is women of reproductive age 15-49 years, with an average of 4.7 children per woman. Thirty-one of teenage girls get pregnant, with only 19 percent of females use modern contraceptives or birth control although there is an upward trend to 31 percent. The maternal mortality rate is 1,070 maternal deaths in every 100,000 live births (Liberia Family Planning Costed Implementation Plan, 2019; National Nutrition Policy 2019-2024).13 This high birth rate has implications on household economy and nurture poverty because most of the teenage mothers are mostly dependent on their parents for support amidst the hard economic condition. 10 https://www.lisgis.gov.lr 11 https://data.worldbank.org (2021) 12 http://worldpopulationreview.com/countries/liberia-population/ 13 Liberia Institute of Statistic and Geo-Information Services (LISGIS); World Population Prospects (2019 Revision) - United Nations population estimates and projections. 16 The Liberian households’ size ranges from 3.7 to 4.9 persons per household with an average household size of 4.3. Access to well diversified diet is low, there is high illiteracy amongst women, there is early childbirth among adolescent girls 15-19 years (Liberia Family Planning Costed Implementation Plan, 2018-2022 pg: 19), lack of adequate safe water and sanitation, behavior change challenges and inadequate access to health services in mainly rural areas, part of the population live in communities where distance to health centers are more than an hour walk or 5km. The high rate of food prices amid economic challenges and all the above further compounds the nutrition challenges in country. Malnutrition is a public health concern in Liberia because it compromises a child’s cognitive development and physical ability and hampers the health of other vulnerable groups including women, adolescents, elderly, people living with HIV and tuberculosis. Additionally, it increases poverty, food insecurity, poor dietary uptake, low education performance and related to poor access to basic social services (National Health Policy, 2008). “Malnutrition is both a cause and consequence of poverty; it negatively affects all aspects of an individual’s health and development and further limits societies’ economic and social development."14 According to the 2019-20 Liberia Demography and Health Survey, 3 percent of children under five are classified as acute wasting while 11 percent underweight. The proportion of children who are underweight is high in River Cess County at 20 percent and low in River Gee County at 7 percent. Anemia is a major public health problem in Liberia affecting 71 percent of children, 55 percent of adolescents and 52 percent of pregnant women. Exclusive breastfeeding among children younger than age 6 months has remained stable at 55 percent since the 2013 LDHS. Stunting rate among children under-5 years is 29.8 percent15 , which is classified as “very high” according to WHO standard and effects all 15 counties of the nation. Thus, stunting reduction is a national priority. Although the focus is on undernutrition, the burden of over-nutrition is growing as the proportion of overweight children has increased since 2013, from 1 percent to 4 percent. Malnutrition negatively affects children's capacity to grow to their full potential especially stunting which lower a child’s ability to perform well in school. Stunting can negatively affect a child’s brain function, organ development, and immune system, which can result in poor achievement at school. Thus, decreasing productivity, earnings in adult life, greater risk of developing obesity and diabetes later in life, ultimately, diminishing chances of escaping the cycle of poverty (UNICEF, 2018). 1.1.5 Socioeconomic Status Liberia’s poverty levels reported in the 2020 Global Nutrition Report indicates that 45 percent of Liberians live on less than 1.90 United States dollars per day and about 76 percent live on 14 USAID Multi-Sectorial Nutrition Strategy 2014-2025 15 https://globalnutritionreport.org 2022 17 less than3.20 United States dollars per day (World Bank, 2020). The Gross Domestic Product (GDP) per Capital was 1,450 United States dollars in 2020, a decrease from more than1,600 United States dollars in 2016. There is a high level of inequality income amongst the population at 65/160 according to the Gini Index which potentially affects households’ economy and food consumption (World Bank, 2020). Liberia ranks 162 with the highest level of inequality in socioeconomic status (UNICEF, August 2020). 1.1.6 Education and Literacy Liberia still has one of the world’s highest levels of Out-of-School children, with an estimated 15 to 20 percent of 6 to14yearold who are not in class. In 2018, about 912,000 students were enrolled in primary and secondary schools of which 74 percent were in Primary schools but with large number of them been overage due to delays caused by Ebola virus outbreak in 2014-2016.In Liberia, the gender parity index in relation to the gross attendance ratio is 0.99 at both primary and high school levels. The literacy rate in Liberia is 47.6 percent ranking Liberia 156th in the world. There is high illiteracy amongst women, whereby 31percent of the females and 13 percent of the males has never had any formal education (UNICEF, 2018). 1.1.7 Access to Basic Health Services One of the fundamental rights of every human being is to be able to enjoy the highest attainable standard of health. Contrary to this, the health system of Liberia continues to experience a rising expectation and demand for access to quality health care services with challenges of shortage and poor distribution of human resources; inadequate number of health infrastructures; ineffective procurement and supply chain management systems. This results into frequent stock-out of drugs and supplies; and a weak health management information system that constrains adequate planning and performance monitoring being reported to fraught the health care delivery system (WHO AFRO, 2019). High-level meeting with the Vice President of Liberia and nutrition stakehold ers to build consensus of the Nutrition Costed PlanHigh-level meeting with the Vice President of Liberia and nutrition stakeholders to build consensus of the Nutrition Costed Plan 18 19 LIBERIA NUTRITION SITUATION ANALYSIS 2 20 2.1 Introduction Malnutrition remains a major public health concern in Liberia that is affecting mostly children under-five, pregnant and lactating women, adolescents, and persons of specific ill-health and vulnerability. Malnutrition can compromise a child’s cognitive development and physical ability and hampers their health and wellbeing. Additionally, it increases poverty, food insecurity, poor dietary uptake, low education performance and relates to poor access to basic social services (National Health Policy, 2008). The major forms of malnutrition found in Liberia are under-nutrition, micronutrients deficiency, and over-nutrition. Under-nutrition includes wasting, underweight, stunting, and low birth weight. Micronutrient deficiency includes anemia, lack of essential vitamins and minerals. Over-nutrition is also a double burden with overweight and obesity among children, adolescent, women, and men increasingly. 2.1.1 Trends of malnutrition in Liberia The trend of malnutrition in Liberia, from 2000 to 2020, shows that significant progress has been made in reducing the levels of malnutrition. With regards to underweight, 11 percent of Liberian children are underweight, with 3percent classified as severely underweight. By region, the proportion of children who are underweight is highest in northwestern at 16 percent and lowest in central at 9.3 percent. Among the counties, the prevalence of underweight is highest in River Cess at 20 percent followed by Grand Cape Mount at 17.7 percent and lowest in River Gee at 7.2 percent. The prevalence of stunting among children under-five years has shown a downward trend of 15 percent reduction, while wasting has reduced from 7.4 percent to 3 percent, and anemia has decreased from 79 percent to 71 percent. There has been no significant progress made in reducing overweight among children under-fives. Prevalence of overweight among children in 2000 was 4.1 percent and increase to the highest overweight at 5.2 percent in 2003 and lowest was 3.2 percent in 2012 and further increase to 4.7 percent by of 2020 ( https://www.ceicdata. com>liberia). 2.1.2 Trend of Stunting Liberia has made some progress in stunting reduction from 45 percent to 30 percent between 2000 and 2020 (UNICEF, 2018). According to the 2022 Global Nutrition Report, stunting rate among children under-5 years has further reduced to 29.8 percent. This progress puts Liberia amongst 21 countries globally which are on track to meet the World Health Assembly (WHA) 2025 targets of 40 percent reduction (WHO, 2020). However, stunting continues to affect around one-third of children under five years, i.e.,265,000 children. In the worst affected counties, River Cess, stunting is at 41 percent, Bong 37.4 percent i.e., over 7 percent higher than the national average. Even in the least affected area (Greater Monrovia), stunting is still 2 21 20.7 percent. These data mean that the stunting level in Liberia is classified as “high” based on the World Health Organization (WHO) thresholds: 20 to 30 percent. The prevalence of stunting decreases during the first 5 months of life and then increases until the 12th month. This is followed by a decrease until the 19th month, after which there is a rapid increase and a peak at 46 percent in the 33rd month. Stunting rates are spatially distributed across the country with geographical variations. The prevalence of stunting is lower in the South-Central region at 25 percent than in the other regions at 33 to 34 percent. Among the counties, the prevalence of stunting is high in River Cess at 40.6 percent and low in Montserrado at 20.7 percent. This indicates the urban and rural disparities. Below is Figure 2, the map of Liberia indicating stunting rates in each county based on the 2019/2020, LDHS. The map of Liberia below shows stunting rates among children under-5 using the color code of WHO to indicate the severity of stunting prevalence in country. Fourteen out of 15 counties are coded Red indicating “Very High” while only Montserrado County, which hosts the capital Monrovia, is colored Orange indicating stunting prevalence as “High”. The level of stunting prevalence demands consented efforts of all stakeholders to reverse this crucial situation to ensure a better future for Liberian children. As of 2022 more than 20,000 under-5 are targeted for treatment whilst some 190,000 i.e., 24 percent of under-five nationwide are targeted for prevention from malnutrition (MoH Forecast, 2022). Figure 1: Trend of Stunting and Wasting in Under 5s 60 50 40 30 20 10 0 2000 2007 2010 2013 2016 2019 Stunting Wasting 7.4 7.9 4 5.6 4.3 3.4 45.3 39.6 39 32.1 30.1 29.8 Figure 1: Shows trend of under 5s Stunting & Wasting prevalence over the last 19 years in Liberia. Data source: Global Nutrition Report, 2022. 22 2.1.2 Trend of Wasting Three percent of Liberian children are wasted, and one percent are severely wasted (-3 SD), figure 3 below: There is regional variation in wasting with the highest being 5.0 percent in northwestern, followed by 4.7 percent in south-eastern, 3.8 percent in the Southeastern and South-central. These levels are above the national average of wasting which is three percent except the North-central which is 2.2 percent. Among the counties, the prevalence of wasting is high in Maryland at 8.0 percent followed by Bomi at 5.7 percent and low in Lofa and Margibi counties at 1.2 percent. Wasting is similar among boys at 4 percent and girls at 3 percent. Wasting may result from inadequate food intake or from a recent episode of illness or infection causing acute weight loss or lack of sanitary environment, including access to safe water, sanitation, and hygiene services. Unlike with stunting, there is no clear relationship between the prevalence of wasting and mother’s education. However, wasting increases with increasing wealth status before dropping among children in the highest wealth quintile (UNICEF, 2018). Figure 2: Under 5s Stunting rates in counties Figure 2: Stunting rates in Liberia for > 5s Source: https://www.WHO.int>team 23 2.1.4 Trends of Micronutrient Deficiencies Anemia is a condition that is marked by low levels of hemoglobin in the blood. Iron is a key component of hemoglobin, and iron deficiency is predominantly responsible for half of all anemia globally. Anemia is a public health concern in Liberia. The prevalence of anemia is high among children under-five at 71 percent. Among adolescent girls within the age range of 15 to19 years, anemia is 55 percent and among women of childbearing age anemia is 45 percent, figure 4. The prevalence of anemia is 52 percent among pregnant women which may contribute to high incidence of low birth weight as well as maternal and infant mortality. Women living in rural areas at 47 percent are more likely to be anaemic than those living in urban areas at 43 percent. By region, the prevalence of anemia ranges from 37 percent in North-central to 52 percent in North-western. By county, the prevalence is high in Grand Bassa at 59 percent and low in Nimba and Lofa at 35 percent. Women are at risk of iron-deficiency anemia because of blood loss from their monthly menstruation and high blood supply demands during pregnancy. The causes of anemia include malaria, hookworm, and other helminths. Other nutritional deficiencies include inadequate dietary intake, chronic infections, and genetic conditions. Figure 3: Under 5s wasting prevalence by counties Very low (<2.5%) Low (~2.5 - 5%) Medium (~5 - 10% ) High (~10 - 15%) Very high (>15%) Wasting by prevalence Gra nd C ape M ount 4.6 % Gbarpolu 4.6 % Lofa 1.2 % Nimba 2.3 % Bong 2.8 % Grand Bassa 2.8 % River Cess 4.9 % Sinoe 2.2 % Grand Gedeh 4.8 % River Gee 3.3 % Grand Kru 1.2 % Bomi 5.7 % Montserrado 3.7 % Margibi 5.0 % Maryland 8.0 % 24 2.1.5 Overweight & Obesity Trend The trend of overweight prevalence among Liberian children under five is 3.4 percent according to UNICEF/WHO/World Bank joint report 2023. Overweight results from an imbalance of energy consumed and energy expended. One out of twenty children under-five is overweight. There is some regional variation, for instance, six percent of children in North-central Liberia are overweight, as compared to south-eastern with two percent. The proportion of children who are overweight is high in River Gee County at 11 percent and low in Grand Gedeh and Grand Kru counties at one percent and one in four women is overweight. Poor quality diet, economic, sedentary lifestyle, and empowerment inequalities, lifestyles are all contributing factors to overweight. Overweight places a huge strain on the fragile health care system that is also grappling with managing other diseases. Cardiovascular diseases and other Non Communicable Diseases (NCD) as well as cancer, respiratory diseases, and diabetes are increasingly becoming significant causes of morbidity and mortality in Liberia (CEIC, 2020). Figure 4: Prevalence of Anemia in WRA (2000-2020) Figure 4: Prevalence of Anaemia in Women of Reproductive Age (2000 - 2020) Data Source: Global Nutrition Report, 2022 25 Trend in Feeding Practices among Children In 2000, 35.4 percent of mothers exclusively breastfed children from 0-6 months but the practice sharply dropped to 29.1percent and further increased to 55 percent in 2020 and 55.2 percent in 2022. The remaining 44.8 percent of children who are not exclusively breastfed is are risk that could hamper growth and life. This puts Liberia above 44 percent in the region and 43 percent worldwide. Figure 5 below shows that exclusive breastfeeding of children 0-6 months is practice by women in Rivercess County at 15 percent, while only 3 percent of mothers practice exclusive breastfeeding in Lofa and Greater Monrovia respectively. This means that children within Lofa and Greater Monrovia are most vulnerable to early morbidity and risks of death than children in other parts of the country. Figure 5: Trends of Thinness, overweight & Obesity in children & adolescents Figure 5: Trend of Thinness, Overweight and Obesity amongst children and adolescents over the last 19 years Data Source: Global Nutrition Report, 2022 26 Figure 6: Exclusive Breastfeeding practices across Liberia Figure7: Infant & Young Child Feeding practices Figure 6: Exclusive Breastfeeding practices across Liberia Source: CFSNS 2018 Figure7: Infant & Young Child Feeding practices Source: UNICEF/WHO 2018, LDHS 2019/2020 27 2.2 Causes of Malnutrition and Interventions Overview According to Lancet Series vol. 382, maternal and child undernutrition and overweight in low and middle-income countries are immediate, underlying, and basic causes of malnutrition. Immediate Causes: The immediate causes include inadequate dietary intake, sub-optimal feeding, inadequate caregiving and prolonged diseases. Interventions include nutrition–specific actions such as adolescents’ health and preconception nutrition, maternal dietary supplementation, promotion of immediate, exclusive and continue breastfeeding. Additionally, micronutrient supplementation, food fortification, maternal, infant, and young child dietary supplementation and dietary diversification are essential interventions. Others include feeding behaviors, caregiving, stimulations, prevention and treatment of severe malnutrition and disease in addition to emergency nutrition support when and where needed. Underlying Causes: The underlying causes include household food insecurity, economic and access to food utilization, inadequate caregiving practices, unhealthy household environment, inadequate access to healthcare services and poor access to food systems. Intervention that addresses the underlying causes are nutrition-sensitive actions such as agriculture and food security, water, sanitation and hygiene, social safety nets, early child development and classroom education, women empowerment, maternal and mental health, child protection and family planning services. Basic Causes: The basic causes include lack of knowledge, access to economic, employment, income generation, social opportunities, inadequate physical, financial, human, and social capitals, including poor political leadership, governance, and environmental context. Interventions include building an enabling environment that is based on enacting laws, legislations, and guidelines to safeguard nutrition. Also, vigorous monitoring, evaluations, advocacy, coordination, capacity enhancement, resource mobilization, transparency, accountability, data generation, verification, validation, and timely reporting address basic causes of malnutrition. 2.3 Determinants of Malnutrition in Liberia 2.3.1 Food Security The Global Hunger Index score for Liberia in 2022 is 32.4 indicating Liberia’s level of hunger as serious16 with 20 percent of households consuming suboptimal diets. About 18 percent of households are food insecure, with 20 percent of households consuming diets deprived of the 16 28 most needed nutrients found in animal products, legumes, vegetables, and fruits. Poor diets are intrinsically linked with poverty and breed malnutrition (WFP, 2018). Pervasive poverty affects 50.9 percent of the population, contributing to Liberia’s ranking175/189 on the 2022 Human Development Index17 . Despite the adequate rainfall and fertile soil to produce needed food, yet Liberia depends heavily on importation of rice (the national staple food). Liberia imports 60 percent of rice consumed making the country vulnerable to any price fluctuation and risking malnutrition among the citizenry (LISGIS et all, 2014). Amid high food prices compounded by the harsh economic conditions in the country, high unemployment rate, citizens continue to face the challenge of food affordability. Access to farmland varies from county to county with 30 percent of rural farmers lacking access. In addition, bad road conditions linking farms to markets, locally produced food products do not reach markets in adequate quantities, further reinforcing accessibility challenges faced by the citizens. Inadequate diet diversity, poor care and feeding practices, poor sanitation and illness are the main drivers. Unemployment is about 80 percent with male 77 percent and female 94.1 percent. Close to 68 percent of the Liberians work in the informal sector with no formal wages. Inequality in the wealth distribution in the country is high. Liberia ranks as the 8th lowest and is among the 10 most unequal countries (UNDP, 2018). The government’s Pro-poor commitment and prioritization of gender equity, as articulated in the Liberia National Gender Policy, lays the foundation measures for appropriate services to be available and utilized by all persons, regardless of gender or status. However, the impact of these policies is limited. 2.2.2 Care & Feeding Practices Exclusive breastfeeding rate is at 55.2 percent (GRN, 2022) among children aged 0-6 months and only 11 percent of children aged 6 to 23 months are fed with minimum dietary diversity, while 3 percent of children aged 6-23 months receive adequate quantity and quality diet. Although mothers understand the importance of breastfeeding and provision of colostrum, proper feeding, and care of children during illness remains limited. The percentage of Liberian mothers who initiate breastfeeding within the first 1 hour following delivery is 67 percent, while 37 percent continued breastfeeding 20-23 months as compared to 50 percent within the region and 45 percent worldwide18 (UNICEF, 2018).Mothers who exclusively breastfeed children from 0-6 months are 55 percent, while 2 percent of mothers breastfeed with plain non-milk liquids. Twenty-two percent of mothers give breastmilk plus plain water and similarly 22 percent still feed with bottles against Maternal, Infant, Young Child Nutrition (MIYCN) standards. However, 78 percent of children 12-17 months are fed with breastmilk and timely complementary food (UNICEF, 2018). Liberia has no law governing breastfeeding; however, the 54thNational Legislature (House of Representatives) passed into law the Code of Marketing of Breast-Milk Substitutes (CMBS)on March 22, 2022. 17 https://hdr.undp.org 18 Data.unicef.org (2022 Liberia) 29 Traditional practices such as “peppering” (giving children a solution of pepper) and forced feeding are especially pronounced in Southeastern Region of Liberia. Infant and maternal mortality is associated with the poor nutrition status of pregnant women which is linked to underlying cultural factors such as nutrition taboos, GBV, teenage pregnancy and early marriage. 2.2.3 Water, Sanitation and Hygiene One of the 17 global goals that encompass the 2030 agenda for Sustainable Development is universal access to clean water and sanitation. However, Liberia still lacks the basic infrastructure to provide safe drinking water and proper sanitation for its population. As reported in the LDHS 2019/2020, at least 84 percent of households have access to improved water sources such as hand pumps, tube wells, boreholes, bottled water, sachet water or protected dug well (Ministry of Public Works, 2017). On the other hand, the percentage of households with access to improved sanitation increased from 28 percent in 2017 to 47 percent in 2019 with 95 percent in urban and 65 percent in rural areas (LDHS-2019/2020). Forty-six percent had access to improved sanitation facilities, compared to less than 10 percent who had access to safely managed drinking water and sanitation services in 2017(UNICEF, 2017). Despite the health risks of open defecation, 48 percent of Liberia’s population practice open defecation (NWASH, 2022). A national roadmap has been developed to roll out the five-year plan (2022-2026) to end open defecation nationwide. Diarrhoea and pneumonia, which are linked to unsafe drinking water and poor hygiene habits, undermine the nutrition status of children and are leading causes of child death in Liberia. This strategic plan has demonstrated how WASH interventions can adapt nutrition-specific programmes to permit delivery of WASH interventions efficiently and effectively using joint advocacy approaches. 2.2.4 Health The Health System is challenged with providing services equally to the population in urban and rural areas of the country. There is inequality which does not reflect the size of catchment population. In rural areas, most people have to walk for more than an hour to seek medical attention at the nearest health center, thus resulting in alternative sub-standard treatment sources for the rural population. The cost of health care in Liberia is still challenging for the population, especially for the unemployed and vulnerable groups living in the rural setting. Although the GoL has a decentralized health care system, health facilities are inadequate, limited skilled health staffs, undeveloped health services, shortage of medicines and medical supplies. Deplorable roads to health facilities make life unbearable for the sick, especially women in labor. The Ministry of Health (MoH)nutrition program is also decentralized at the county, district, and community levels. 30 There are still challenges at the relevant ministries for adequately trained nutrition focal persons to ensure the implementation of nutrition sensitive programs. Great efforts have been made by the SUN Secretariat in coordinating the Multi-stakeholders Platform (MSP) for nutrition in the country by ensuring collaboration amongst relevant partners, advocacy, awareness, and representation. 2.2.5 Human Resource for Nutrition The health sector lacks adequate logistics, financial and human resources, especially nutrition staff. The WHO standard for West Africa in terms of nutrition staff required is 700 per population of 5 million but currently stands at 250 per 5 million. There is a serious gap among nutrition service providers at the MoH most especially at B.Sc. level than the M.Sc. level (https://www. who.int>volume). Specialty in the nutrition sector is in the embryonic stage among health workers in Liberia. Information from MoH indicates a total of 1 nutrition staff in each of the 11 counties at county health team level and the other3 counties; Bong, Nimba, Lofa have 2 each and Montserrado county has 3 County Nutrition Supervisors, making a total of 20 County Nutrition Supervisors. Most of the nutrition services that are currently been provided at health centers are administered by non-nutrition specialists or health staff who have been trained in-house. The National Nutrition Policy lays out a plan for capacity strengthening through formal and in service training to augment the capacity of Nutrition staff. The present health policy focuses on mainstreaming nutrition into the Public Healthcare System to augment the staffing gap. 2.2.6 Women’s Education and Empowerment Inequality in wealth distribution in the country is very high. Liberia ranks as the 8th lowest and is among the 10 most unequal countries (UNDP, 2018). The government’s Pro-poor commitment and prioritization of gender equity, as articulated in the Liberia National Gender Policy, lays the foundation measures for appropriate services to be available and utilized by all persons, regardless of gender or status. However, the impact of this policy is limited. According to the United Nations Educational, Scientific and Cultural Organization (UNESCO, 2017)report, adult literacy rate for female in Liberia is 34 percent and unemployment 2.96 percent for these females who are qualified and seeking employment by 2022 (Global Economy Research on Liberia)19. Thirty-eight percent of the women and 41 percent of men in Liberia are engaged in agricultural work. This is a decrease from 55 percent women and 53 percent men in 2017. Fifty-seven percent of the women performing agricultural work are more likely not to be paid making food affordability a challenge (LDHS, 2019/2020). This situation means that women are missing out on the opportunity to participate meaningfully in the socio-economic life and political decision-making process of the country. In 2016, Zone of Influence reported that only 56 percent of women achieve their minimum dietary diversity based on educational attainment, gendered household type, household size and household hunger (USAID, June 2018). 19 https//:www.theglobaleconomy.com 31 2.2.7 Gender Mainstreaming in the LMNCSP Food and Agriculture Organization (FAO) is currently running a mandate in Liberia to achieve equality between men and women through sustainable food production, thereby reducing hunger, poverty, practices of injustice. The domains of gender equality such as attitudes about or experience of gender-based violence have also been reported to have an expansive impact on nutrition and health related outcomes of women, girls and children (NI, 2018). To achieve sustainable and improved nutrition and health outcomes, the LMNCSP aspires to contribute to the on-going efforts of tackling gender inequality through inclusion of men and women in all age cohort groups, including ethnic or religious diversities from the development stage, implementation, monitoring, and evaluation phases of this strategic plan. In addition, gender sensitive indicators in monitoring and evaluation framework have been provided to help in the collection, analysis and reporting of sex disaggregated data which in turn will inform gender transformative programming. Social protection policies and programs have much potential to improve the nutrition situation of the vulnerable population of Liberia. The demand of social protection in Liberia remains large and multi-faceted with the current protection system facing challenges of coordination, collaboration, coverage, funding, and capacity. One of the social interventions implemented through this department is school feeding, demonstrating the relevance of adopting a multi-sectorial approach sensitive to the specific needs of children and adolescents vital in implementing nutrition and social protection programs. Some national interventions target children under five and lactating mothers to have access to finance, agriculture inputs, Agriculture Extension and Advisory Services (AEAS)20. The LMNCSP has ensured to integrate nutrition in social protection interventions to holistically combat malnutrition. 20 https://fao.org>detail High-level meeting with the Vice President of Liberia and nutrition stakeholders to build consensus of the Nutrition Costed PlanWomen's empowerment programme under the Ministry of Gender, Children and Social Protection 32 33 MULTI-SECTORAL STRATEGY DESIGN FRAMEWORK 3 34 3.1 Introduction: The LMNSCP is designed to reduce malnutrition in the country by implementing actions and sub-actions which address the nutrition-specific and nutrition-sensitive challenges in country through a multisectoral approach which involved all relevant actors. The LMNCSP is focused mainly on stunting reduction while seeking to address other forms of malnutrition. It seeks to operationalize the National Nutrition Policy revised in 2019, through the formulation of interventions which address the context, causes and consequences of all forms of malnutrition in Liberia. 3.2 Interventions in Key Sectors The key sectors for interventions are guided by the National Nutrition Policy and Compendium of Actions for Nutrition under the following 1l Thematic Areas: (1) Crops/Horticulture, (2) Fisheries/ Livestock, (3) Food Consumption and Healthy Practices, (4) Food Fortification, Processing and Storage, (5) Prevention and Management of Acute Malnutrition, (6) Maternal Infant and Young Child Nutrition (MIYCN), (7) Multiple Micronutrient Supplementations, (8) Prevention of Nutrition Related Diseases, (9) Social Protection and Gender Empowerment, (10) WASH, and (11) Emergency and Shocks. The actions and sub-actions selected during the national consultation with relevant ministries and agencies (MIA, MICAT, MFDP, MoA, MoCI, MoE, MOGCSP, MoH, MPW, NaFAA, NPHIL, SUN, NWASHC, CSO, County Health Teams, MSPs, etc.) are those deemed relevant to obtaining the objectives of the National Nutrition Policy of Liberia. 3.3 Multi-sector Nutrition Governance The multi-sector approach for the reduction of malnutrition with emphasis on stunting reduction requires an enabling environment for a comprehensive collaboration and coordination between key stakeholders at capital, county, district, and community levels. This will result to achieving high-impact, nutrition specific and nutrition-sensitive outcomes. The SUN Secretariat leads the multi-stakeholders’ platform which ensures coordination amongst various stakeholders who contribute to the multi-sectorial interventions. Key sectors such as agriculture, health, education, social protection and social safety net, early child development, water, hygiene and sanitation, and the private sector are essential in addressing the underlying and basic causes of malnutrition. Some important actions that contribute to the enhancement of an enabling environment for nutrition include: 1. Increase in financial resource allocation for nutrition activities or projects at the county/district levels by the Ministry of Finance and Development Planning. 2. Strengthening the capacity of relevant frontline staff in the nutrition departments of the various line ministries for nutrition-specific and nutrition 3 35 sensitive activities. 3 Coordination mechanisms should be active and encouraged to bring together sectors specific technical expertise through the conduct of meetings for information sharing and technical advice and nutrition governance. 4. Efforts should be made to foster collaboration between private sectors, CSO, religious groups and all relevant stakeholders to ignite their interest in nutrition programs. 5. Continued advocacy should be held for the enactment of legal instruments which protect and promote nutrition in the country. 3.4 Nutrition-Specific Interventions The Nutrition Specific interventions expected to address the immediate causes involve 10 Direct Nutrition Interventions (DNIs) which require material, financial, human and logistics resources. The DNIs are currently being implemented in Liberia by the GoL through the MoH, UNICEF, and other multiple partners. UNICEF is supporting the government to increase the coverage of nutrition services. The DNIs include interventions such as the promotion of exclusive breastfeeding, food fortification, treatment of severe acute malnutrition, hand washing for disease prevention, de-worming, micronutrient supplementation and pre-pregnancy and adolescent nutrition. The 10 DNIS are: 1. Promotion of adolescent and pre-conception nutrition 2. Iron folic supplementation for pregnant women 3. Support for food fortification 4. Promotion of optimal breastfeeding 5. Multi micronutrient (MNP) supplementation for children aged 6-23 months 6. Vitamin A supplementation 7. Promotion of appropriate complementary feeding 8. Treatment of severe acute malnutrition 9. Promotion of hand washing for disease prevention 10. Deworming for children aged 6-12 months. The GoL, through the MoH provides human and financial resources, non-financial assets, administrative and policy support to implement the DNIs. 3.5 Nutrition-Sensitive Interventions In addition, there are Nutrition Sensitive interventions which involve relevant Government line ministries, agencies, United Nations agencies, development partners and other multiple partners, civil society, religious and community level actors at national and sub-national levels. Focus is placed on those interventions which are linked to existing Food Systems including Agriculture, Food security, Education, community health, Non–Communicable Diseases and Injury (NCDI), and family planning, WASH, Gender, social protection and safety nets, 36 food quality controls and price regulations, access road, and private sectors partnership for nutrition, food fortification and support to small enterprise for production of complementary food for children. 3.6 Nutrition Governance The creation of enabling environment and nutrition governance to safeguard nutrition which include enacting legislations, policies, regulations, monitoring, evaluation, accountability, reporting, transparency, coordination, advocacy, and resource mobilization. Capacity strengthening is also another vital area to be considered. 3.7 National Policy and Legal Framework for the LMNCSP The LMNCSP is well grounded on the National Nutrition Policy (NNP, 2019-2024 chapter 3,&4 pages 20-230), the National Health and Social Welfare Policy (NHSWP, 2011-2021-Chapter 2.3.5, Pg.7, chp.3 page 12-13 Policy Foundations), the National Gender Policy (NGP, 2010– 2015), the National Food Security and Nutrition Strategy (NFSNS,2008, pg.7) which highlights food security and improved nutrition as national priority. Better food utilization for improved nutrition and the Comprehensive Food Security and Nutrition Survey (CFSNS, 2018) support the PAPD as indicated in Pillar 1 (PAPD, 2018-2023) and the Vision 2030. The Liberia Demographic Health Survey conducted from October 16, 2019, to February 12, 2020, has provided updated nutrition data used in this document. The NNP 2019-2024 also emphasizes the following: 1. Strong Political Will, Gender Equality, and mainstreaming, 2. Decentralization in health delivery and management, 3. School Health and School Feeding, and 4. Focus on Adolescent nutrition. 3.8 Nutrition a Universal Human Right Health and Nutrition are the fundamental rights of children as indicated in the Universal Declaration of Human Rights, 1948, as ascribed in Article 25 setting the right to food, medical care, and basic social services as the requirements for the wellbeing and health of every individual and family. The principle is further emphasized in the Preamble of the Constitution of the World Health Organization in 1946 as a precondition for individual and societal development. Further to these are the United Nations Convention on the Rights of the Child (CRC) Article 6 “the right to life”, Article 24 “the right to health and medical care” and Article 27 on the right to good and adequate standard of living, including food. These rights are also backed up by Article 14 of the African Charter on the Rights and Welfare of the Child, 1992. Liberia has also passed into law the Children’s Law of Liberia in 2011 which Section 8.2 and Section 10 clearly state the rights to access adequate food, safe and clean water, nutrition, and health care. Other international regional obligations include the adherence to the U.N. Sustainable Development Goals (SDG 2) and 3 that require nations to end all forms of hunger and malnutrition, especially for children, by 2030. SDG 2, Target 2.2 says “end all forms of malnutrition”, including to achieve by 2030 the internationally agreed targets on stunting and wasting in children under-5 years. Address the nutrition needs of adolescent girls, pregnant 37 and lactating women and older persons and “Achieving Zero Hunger.” The SDG 3 indicates Achieving Good Health and Wellbeing and stresses the need for multi-sectorial, rights-based and gender-sensitivity approaches to address inequalities and to build good health for all. Other SDG goals which are closely related to Nutrition and Health include Goal 1: No Poverty, Goal 4: Quality Education, Goal 5: Gender Equality and Goal 6: Clean Water and Sanitation. In fact, nutrition seems central to all the 17 SDGs and each member state is expected to make efforts to achieve these goals. a) Political will and awareness of the importance of nutrition at all levels The solutions to eradicating malnutrition in Liberia go beyond the walls of the Ministry of Health. For this reason, different stakeholders across different sectors; line ministries, development partners, non-governmental organizations (NGOs), faith-based organizations (FBO), community-based organizations (CBOs), civil society organizations (CSOs), donors, research institutions, private sector, the mass media, and academic training institutions, will be engaged to steer the implementation of this strategic plan towards achieving optimal nutritional status for all Liberians. This is further expressed in the PAPD Pillar1 that emphasizes the reduction of stunting to 22 percent by 2023. b) Adequate financial resources The Government of Liberia seeks to commit itself in the intensive mobilization, proper utilization and accessing financial resources to help in expanding the coverage of nutrition interventions without compromising the quality. As a long-term trend in Liberia to reduce foreign assistance, the government seeks to promote domestic financing for the implementation of the interventions in the strategic plan. c) Coordination The Government of Liberia recognizes that every individual has an important role in improving the nutrition status of the country thus endeavors to build an environment that encourages participation, collaboration and incorporation of diverse skills and capabilities across all sectors. d) Decentralization This strategic plan recognizes the power of a devolved system pulling together the leadership at national, county and district levels to make nutrition and nutrition related decisions focused and targeted for the benefit of all Liberians. e) Community participation and involvement The Government of Liberia recognizes that a healthy community is a healthy nation because the community is the heart of the nation. For this reason, this strategic plan looks forward to partnering with community actors in mapping nutrition needs, planning and implementation of different nutrition interventions using a community-based approach towards eradicating malnutrition. 38 f) Prioritizing the most nutritionally vulnerable populations In Liberia, those considered as nutritionally vulnerable include infants, children under five years, school age children, adolescents, pregnant and lactating women, People Living With HIV/AIDS (PLWHA), TB patients, victims of disasters/ emergencies and geriatrics. A holistic approach will be advocated to protect and promote the nutritional status of the named vulnerable groups as identified in this strategic plan. g) Gender mainstreaming This strategic plan seeks to ensure the needs and concerns of the boys, girls, men, and women are considered and given the need for the promotion of gender-sensitive policies and activities in nutrition. h) Adequate and skilled human resources There is a mutual relationship between health, nutrition, and human resource development. This strategic plan understands the need to strengthen human resources for nutrition through capacity building with an increased awareness of promoting gender equality. i) Evidence-based planning The LMNCSP will seek to address the real issues without compromise as identified by the nutrition stakeholders and as reported in the retrieved data from different sources in the country guided by: i. Evidence-based decision making ii. Monitoring and evaluation of the implementation of nutrition services iii. Timely course correction iv. Promoting accountability among duty bearers to provide nutrition service. The LMNCSP demonstrates the need for collaboration and coordination using the multi sectoral approach across actors in the government, private sector, research, and national development partners to manifest coherence between policies and strategies. The main policy context for the Liberia Multi-Sector Nutrition Costed Strategic Plan is detailed in the National Nutrition Policy as follows: 1. Strong Political Will, Gender Equality, and mainstreaming, 2. Decentralization in health delivery and management, 3. School Health and School Feeding, and 4. Focus on Adolescent nutrition. The LMNCSP serves as the strategic implementation framework for the NNP. The Liberia Multi-Sector Nutrition Costed Strategic Plan is founded on the following Vision, Mission, Goal, Objectives, and Strategies which are 39 High-level meeting with the Vice President of Liberia and nutrition stakeholders to build consensus of the Nutrition Costed Plan Anthropometric measurement for growth monitoring of children 40 41 VISION, MISSION, GOAL, OBJECTIVES and STRATEGIES 4 42 4.2 MISSION To scale-up the coverage, accessibility and utilization by individuals and communities of nutrition-specific and nutrition-sensitive interventions which prevent stunting and other manifestations of malnutrition 4.1 VISION To achieve optimal nutritional status for all Liberians through the implementation of both nutrition-specific and nutrition-sensitive interventions across sectors 4.3 GOAL The overall goal of the LMNCSP is to reduce stunting from 29.8 percent rate among the under-5 in 2023 to 18 percent by 2028 and any other forms of malnutrition, by accelerating interventions and activities which are nutrition-specific and nutrition sensitive through multi-sectoral approaches. 4 43 4.4 OBJECTIVES The strategic objectives of the LMNCSP as stipulated below are clearly elaborated in the NNP and provide the scope of which the National Nutrition Response should be implemented. 4.6 TARGET AUDIENCE OF THE MULTI SECTORAL NUTRITION STRATEGY The target audience for the LMNCSP includes (1) Healthcare Planners, (2) Policy Makers, (3) Policy implementers at both national and county levels, (4) Nutrition-specific and Nutrition-sensitive sectors at all levels, (5) Nutrition staff at all levels; other actors include: (6) Development partners, (7) non-governmental organizations (NGOs), (8) Faith-based Organizations (FBO), (9) Community-based Organizations (CBOs), (10) Civil Society Organizations (CSOs), (11) Donors, (12) Research institutions, (13) Private sectors, (14) the media, and (15) Academic Training Institutions. This will enable them to understand how their active support towards the implementation of the LMNCSP will contribute to the achievement of optimal nutrition for all Liberian citizens and eradicate malnutrition in all its forms. 4.5 PURPOSE OF THE LIBERIA MULTI SECTORAL NUTRITION COSTED STRATEGIC PLAN (LMNCSP) The purpose of the Liberia Multi-sectorial Nutrition Costed Strategic Plan is to outline the operationalization of the strategic implementation of the National Nutrition Policy document in Liberia through a collaborative and coordinative approach among all relevant stakeholders. This is to ensure adequate support in terms of human, material and financial resources needed to achieve the overall goals and objectives of the National Nutrition Policy. 44 45 STRATEGIC OBJECTIVES, STRATEGIES, and INTERVENTIONS 5 46 5.1 Rationale The National Nutrition Policy has clearly set out the justification for a multi-sectoral approach to tackle the multi-faceted challenges of malnutrition among women and children in Liberia. There are multiple causes of malnutrition in Liberia ranging from direct and indirect causes such as illnesses, food insecurity, poor feeding practices, child health services and WASH, etc. that need to be addressed to achieve the vision as outlined in this strategic plan. Actions required to tackle malnutrition in the country are expected to work towards addressing these root causes to eliminate the negative impact of malnutrition in the Liberian economy. Therefore, this strategic plan uses a multi-sectoral approach to include other line ministries (Agriculture, Social Protection, Education, Gender, Water and Sanitation, etc.) other than the Ministry of Health to address the malnutrition situation in Liberia. Figure 8 shows the Conceptual Framework adopted for the LMNCSP to address the root causes and challenges of malnutrition which reinforces the need for a multi-sectoral approach. 5 Local nutritional fruits in a local market in Liberia. 47 Figure 8: The Conceptual Framework 48 5.2 Theory of Change and Logical Framework The Theory of Change (ToC) is a specific type of methodology used for planning, participating, monitoring, and evaluating the desired change in a context to improve the nutrition status of the people in Liberia. Figure 9: Theory of Change (TOC) 49 The Theory of Change outlined below was used to develop the set of strategic objectives for this LMNCSP. If these strategies are deployed to implement the listed interventions by using efficient and effective mechanism, multi-sectoral approach, viable partnership, community participation and involvement techniques, innovation, and dynamic leadership, then by extension it will contribute to achieving optimal nutrition status of the Liberian citizens and residents. 5.3 Key Strategic Objectives and Strategies The LMNSCP has 5 Major Strategic Objectives that have been defined. The 5 strategic objectives have a set of strategies with corresponding expected outcomes and intervention/activities to be implemented for the achievement of the goal and objectives of NNP. The strategic objectives have further been presented within the implementation matrix. Figure 10: The LMNCSP Strategic Objectives Strategic Objective 1: To ensure improvement access to and utilization of a comprehensive package of proven Direct Nutrition Interventions (DNI) and nutrition specific interventions at all government health facilities by 2028. Strategic Objective 2: To improve the underlying determinants of Malnutrition through multi-sectoral Nutrition Sensitive interventions which compliment Nutrition specific interventions towards ending all forms of malnutrition by 40% in 2028 Strategic Objective 3: To shape positively the enabling environment essential for the attainment of positive nutrition outcomes (nutrition policies, guidelines, laws and legislations, influence policies of other sectors to have nutrition lens) Strategic Objective 4: To improve awareness and practices of positive nutrition behaviors essential for the attainment of optimal nutrition status (demand creation) Strategic Objective 5: To strengthen sectoral and multi-sectoral monitoring, evaluation, learning, accountability, and research in nutrition. 1 2 3 4 5 50 STRATEGIC OBJECTIVES STRATEGIES Strategic Objective 1: To ensure improved access to and utilization of a comprehensive package of proven Direct Nutrition Interventions (DNI) at all government health facilities by 2028 1. Adopt community health initiatives to roll out the Integrated Management of Acute Malnutrition at health facility and community levels. 2. Integrate cross-sectoral linkages to ensure that DNIs (see chapter 3.1 for lists of DNIs) are provided routinely within the Public Health Care System and mainstreamed in other sectors Strategic Objective 2: To address the underlying determinants of Malnutrition through multi-sectoral nutrition sensitive interventions which complement nutrition specific interventions towards ending all forms of malnutrition by 40 percent in 2028 1. Integrate nutrition into WASH policies, strategies, plans and programs. 2. Adopt appropriate technologies for the production, processing, and handling of agricultural products to improve household food and nutrition security. 3. Develop and implement a package of nutrition interventions and operational guidelines appropriate for School going children and adolescents. 4. Develop a nutrition-sensitive package of cash transfer interventions and appropriate operational guidelines for social protection of vulnerable children and adolescents to safe guide their nutrition. 5. Integrate cash transfer programs to provide income support as a social safety net to vulnerable groups to improve health and nutrition of children in targeted households. 6. Enhance an effective and functional institutional system for Disaster Risk Management, enhance risk identification mechanisms; preparedness, emergency response (including nutrition emergency response) and recovery; improve information and knowledge management and vulnerability factors. 7. Solidify systems of relevant government Institutions to ensure emergency preparedness and response. 8. Strengthen community preparedness, response, and recovery for natural and man-made disasters/ outbreaks through national emergency response and recovery strategy. 9. Facilitate the establishment of Nutrition Focal Points in each line ministry of the Government t of the Republic of Liberia Table 1: Summary of Strategic Objectives and Strategies 51 STRATEGIC OBJECTIVES STRATEGIES Strategic Objective 3: To shape positively the enabling environment essential for the attainment of positive nutrition outcomes (nutrition policies, guidelines, laws and legislations, influence policies of other sectors to have nutrition lens) 1. Review, update and /or formulate legislation, guidelines, standards, and code of practice on food quality and safety. 2. Sensitize and inform the public and key decision makers on the importance of food quality and safety. 3. Strengthen Institutional capacity to ensure the monitoring and enforcement of food, sanitary and phytosanitary standards; Consumer education, protection and put in place systems for consumers to express grievances and make suggestions for improvements in food safety. 4. Integrate nutrition goals into national development plans, sectoral policies/plans, programs, and projects. 5. Advocate to improve awareness among decision makers on the %role of nutrition in national development and how sectors can work together to achieve desirable change. 6. Ensure adequate human, financial, material and logistics resources are provided for the implementation of the Linespacing the SUN focal persons at an appropriate level/office within government with convening powers. 7. Promote coordination, advocacy for resource mobilization domestically and externally. 8. Earmark regular and fixed meeting dates in advance for information dissemination. 9. Advocate for the creation of nutrition budget line in the government Fiscal Budget allocation 10. Conduct capacity building to strengthen technical capacity for nutrition program implementation, policy analysis, and development and monitoring of their implementation at all levels. 11. Promote Public-Private Partnerships in nutrition programming 52 STRATEGIC OBJECTIVES STRATEGIES Strategic Objective 4: To improve awareness and practices of positive nutrition behaviors essential for the attainment of optimal nutrition status (demand creation) 1. Create awareness on appropriate dietary practices and lifestyles essential for the prevention of NCDIs particularly targeting groups most at risk. 2. Encourage the formation of pressure groups such as anti-smoking, anti-drug, and anti-alcohol abuse groups, to enhance capacity to combat the problems. 3. Develop a social behavior change communication strategy to increase knowledge and promote positive nutrition behaviors. Strategic Objective 5: To strengthen sectoral and multi-sectoral monitoring, evaluation, learning, accountability, and research in nutrition. 1. Strengthen existing systems and capacity to collect, analyze, report and monitor nutrition situations to ensure the utilization of data for decision-making. 2. Integrate and assimilate standard nutrition indicators into sectoral information systems with a priority for HMIS. 3. Strengthen information systems to ensure the integration, tracking of progress, analysis, and the use of the information for decision-making. 4. Develop the capacity of community and facility based service providers on essential skills and competencies in nutrition. 53 1 5.4 Strategies and priorities for high-impact interventions Strategic Objective 1: To ensure improved access to and utilization of a Comprehensive Package of Proven Direct Nutrition Interventions (DNIs) at all government health facilities by 2028. Expected outcome: Strengthened access and utilized package of the Comprehensive Package of Proven Direct Nutrition Interventions (DNIs) Strategy 1: Adopt Community Health Initiatives to roll out the Integrated Management of Acute Malnutrition (IMAM) at health facilities and community levels. Interventions 1. Procure and distribute Integrated Management of Acute Malnutrition (IMAM) supplies and equipment including outreach and at OTP. 2. Advocate for increased resource allocation, better coordination, plans and commitment for IMAM implementation including commodities, equipment, and Human Resources 3. Integrate MIYCN with IMAM, and IMNCI (Integrated Management of Neonatal and Childhood Illnesses) package and services (social services and livelihood) for prevention strategies at community and household levels. 4. Conduct mass and routine screening of under 5 children to facilitate the identification of individuals with Severe or Moderate Acute Malnutrition (MAM) and refer appropriately. 5. Support out-patient management of SAM, in-patient Management of SAM, targeted supplementary feeding to treat MAM and enhanced nutrition counseling. 6. Disseminate and enhance understanding of IMAM training package for health workers. 7. Develop a costed scaled-up plan to expand access to treatment within the country. 8. Conduct IMAM program performance reviews: cure, defaulter, death, coverage, and linkage with M&E. 9. Arrange for storage for proven dietary nutrition supplies at national and county levels. 54 Strategy 2: Integrate across-sectoral linkages to ensure that DNIs are provided routinely within the Public Health Care System and mainstreamed in other sectors (Promotion of adolescent and pre-conception nutrition; Iron folic supplementation for pregnant women; MIYCN: Promotion of optimal breastfeeding, multiple micronutrient supplementation (MNP) for children aged 6-59 months). Interventions 1) Develop and disseminate a national strategy for adolescent and preconception nutrition. 2) Conduct awareness campaigns on the importance of adolescent nutrition, HIV/AIDS, reproductive health, and WASH using various channels. 3) Provide IFA (Iron Folic Acid supplement to pregnant women at antenatal care (ANC) for 270 days. 4) Provide pregnant women with Insecticide –Treated Nets (ITNs) to prevent malaria. 5) Provide Iron supplementation to children 6-59 months. 6) Provide WIFA supplement and deworming for adolescents. 7) Provide nutrition counseling for PLW. 8) Promote attendance to antenatal and postnatal clinics by PLW. 9) Encourage, monitor, and document mothers who initiate breastfeeding of children within the first-hour of birth. 10) Promote, protect, and support exclusive breastfeeding for children 0-6 months. 11) Encourage and promote awareness on timely appropriate, adequate, and safe complementary feeding for children 6-23 months old with continued breastfeeding for 2 years and beyond. 12) Provide multiple micronutrient powder (MNP) supplementation for children aged 6-59months. 13) Conduct bi-annual de-worming of children aged 12-59 months (two doses). 14) Provide children aged 6-59 months with two doses per year with Vitamin A supplements. 15) Establish mechanisms to collaborate with print and electronic media to scale up maternal, adolescent, infant and young child nutrition practices messaging. 16) Promote celebration of World Breastfeeding Week and other MIYCN global/ national events. 17) Develop and train health workers and community assistants on maternal, adolescent, infant and young child nutrition practices packages. 18) Institutionalize the 10 steps to successful breastfeeding in all health facilities that provide maternity services via Baby-Friendly Hospital Initiative. 19) Develop a multi-sectoral Nutrition Score Card. 20) Conduct nutrition partner’s mapping. 21) Develop a national complementary feeding framework. Strategic Objective 2: To Improve the Underlying Determinants of Malnutrition through 55 2 multi-sectoral Nutrition Sensitive interventions which complement Nutrition Specific Interventions towards ending all forms of malnutrition by 40 percent in 2028. Expected Outcome: Improved multi-sectoral nutrition programming and interventions through Nutrition Sensitive activities which complement Nutrition Specific Interventions and address the underlying determinants of malnutrition in Liberia. Strategy 1: Integrate Nutrition into WASH Policies, Strategies, Plans and Programs Interventions 1) Ensure that relevant sectors formulate and design programs with nutrition lens. 2) Educate, sensitize, and influence social marketing emphasizing links between poor WASH and under-nutrition. 3) Embark on hand washing, education, and promotion always through promotion of environmental hygiene in public areas and domestic facilities. 4) Provision of hand washing supplies and hand washing stations /tippy tapes all levels. 5) Promote environmental hygiene in public areas and domestic facilities. 6) Ensure villages are Open Defecation Free (ODF). 7) Support sanitation facilities design sensitive to vulnerable groups. 8) Improvement of water supply systems and services for access to safe drinking water. 9) Ensure construction and rehabilitation of boreholes and hand-dug wells fitted with hand-pumps to get clean water at community levels. 10) Promote household water treatment technologies and safe storage within households, health facilities and schools. 11) Adopt and review available regional and international WASH standards. 12) Conduct sensitization on safe and hygienic practices during food preparation and storage. 13) Advocate for protection of water sources and regular water treatment quality checks. 14) Strengthen mechanisms for collaboration and promote participation of stakeholders in WASH forums. 15) Support Baby WASH interventions to improve maternal, newborn and child health, early childhood development, and nutrition. 56 Strategy 2: Adopt appropriate technologies for the production, processing, and handling of agricultural products to improve household food security. Interventions 1) Empower and support communities to work on agriculture and educate them on which types of nutrition sensitive food to plant, the importance, and advantages of establishing kitchen gardens and rearing small animals. 2) Educate communities on nutritional quality of common foods that are locally available, culturally accepted, and low cost to enable them to make informed decision when purchasing at local markets. 3) Train community nutrition relevant stakeholders, care givers and households on homestead farming, model gardening, production of stable, irrigation techniques, water banks/reservoirs, smart irrigation, installation of rain gauge, basic mechanized farming which increase production, and reduce women workload. 4) Promote uptake of food processing technology, preservation, storage, and utilization of local diversified food to prevent losses. 5) Establishment of farmers field schools, seed banks and community seed and fruit nurseries. 6) Introduce bio-fortified food crops varieties to support healthy diets. 7) Strengthen the capacity and work with community, caregivers, and Community Health Assistants to provide nutrition sensitive services (e.g., WASH, kitchen garden, nutrition education and awareness). 8) Develop food safety regulations and enforcement mechanisms. 9) Develop social behavior change and communication (SBCC) strategy for increased consumption of nutritious foods and improved dietary diversity including fortified foods. 10) Promote and protect homestead animal rearing to produce animal source food in support of healthy diet. 11) Capacitate farmers to implement fish and insect farming to produce animal source food in support of healthy diets (e.g., fish farming, beekeeping and honey production and value chain, snail-rising, etc. 12) Advocate with ministries of agriculture /partners for the distribution of high nutritious value local seeds, animals, and fisheries to vulnerable households. 13) Advocate for strategies to maintain predictable and stable food imports including cost reduction measures and establishment of strategic food reserve mechanisms. 14) Promotion of year-round production of fruits and vegetable gardens for healthy diets. 15) Enable relevant sectors community stakeholders to provide support and guidance within schools regarding nutrition. e.g., land for school gardens. 16) Negotiate for construction and rehabilitation of farms to market roads to 57 improve access to local markets. 17) Train care groups and households on homestead farming, food processing, preservation, storage, and utilization of diversified foods for improved nutrition status. 18) Ensure the establishment of seed multiplication gardens and related agriculture inputs at the community level. 19) Ensure that relevant stakeholders implement food fortification to improve essential nutrients in diet. 20) Improve access through farm to market roads / feeder-roads rehabilitation / maintenance livelihood, income, etc. 21) Establish yearly crops survey of the production yield during harvest to enable estimate for lean season. 22) Establish a monthly market price monitoring to generate price bulletin of major food commodities. 23) Encourage animal farmers to monitor animal’s biosafety and bio-security measures to keep diseases out of the farm. 24) Timely distribution of agriculture inputs to farmers along with viable seeds. Strategy 3: Develop a package of nutrition and adolescent sexual and reproductive health intervention and operational guidelines appropriate for school going children and adolescents. Interventions 1) Develop standardized supplementary feeding guidelines based on local foods. 2) Support the development of school nutrition curriculum. 3) Monitor the teaching of nutrition education in schools (primary and secondary). 4) Conduct cooking demonstrations to promote optimal nutritious food including choice and combinations at schools. 5) Promote nutrition education for improved dietary diversity and food hygiene education to safeguard nutrition for school going children and adolescents. 6) Review school health strategy and school feeding guidelines to ensure coherence with the LMNCSP. 7) Ensure schoolgirls take home ration to safeguard nutrition. 8) Advocate for the setting up of hand washing posts on school campuses. 9) Ensure support to home-grown school feeding Program. 10) Establish school gardens for agriculture production to increase nutrition knowledge for new learners. 11) Promote school health and nutrition programs for healthy diets and good nutrition. 12) Enable relevant sectors community stakeholders to provide support and guidance within schools regarding nutrition. e.g., land for school gardens. 13) Sensitize school going children and adolescents on healthy diets and physical 58 activity using context-specific communication channels. 14) Integrate messaging on healthy diets and physical activity in the school health program. 15) Regulate the food environment to control marketing of unhealthy foods for school going children and adolescents and sensitize school stakeholders on marketing and promotion of sufficient, safe, and nutritious foods in school. Strategy 5: Integrate cash transfer programs to provide income support as social safety-net to vulnerable groups to improve health and nutrition of children in targeted households. Interventions 1) Support the implementation of cash transfers to households with poor children and adolescents. 2) Lobby with stakeholders to provide support that are nutrition sensitive to increase the capacity of vulnerable households. 3) Encourage nutrition sensitive village saving loans (susu) in care groups activities for economic empowerment of women in vulnerable families. 4) Provide unconditional cash transfers to safeguard healthy diets, particularly to vulnerable pregnant and lactating women and young children integrated with nutrition education. 5) Support provision of specialized food transfer to women and children to safeguard maternal, infant, and young child nutrition. 6) Ensure cash transfers or other forms of social transfers to empower vulnerable communities and households’ affordability of food, prioritizing pregnant women and child-headed households. 7) Advocate for the implementation of maternity cash transfers as social protection safety-net programs to reduce financial barrier to good nutrition. Strategy 6: Enhance an effective and functional institutional system for disaster risk management. Enhance risk identification mechanisms: preparedness, emergency response and recovery. Improve information, knowledge management and vulnerability factors. Interventions 1) Develop contingency plan and standard operating procedures (SOP) for nutrition emergency response. 2) Train frontline staff to conduct nutrition surveillance and response in time of emergencies. 3) Strengthen the capacity of frontline staff to identify vulnerable groups in time of disaster or epidemic to reduce risks of malnutrition. 4) Procure and pre-position nutrition emergency supplies in all counties and districts. 5) Assess impact of disaster or epidemics on the nutrition status of vulnerable 59 groups. 6) Formulate nutrition strategies for post-emergency community recovery. 7) Map partners in disaster risk management and emergency response and recovery. 8) Establish functional disaster risk management committees. 9) Train stakeholders on disaster risk reduction. 10) Conduct, review and disseminate early warning surveys. Strategy 7: Solidify systems of relevant government institutions to ensure emergency preparedness and response. Interventions 1) Conduct and document outcomes of coordination meeting and joint planning on nutrition during emergencies. 2) Mobilize resources for nutrition interventions for emergency response. 3) Conduct routine mass screening for timely detection of undernutrition in adolescents and adults and refer for appropriate actions. 4) Build capacity of systems and individuals to undertake preparedness and response functions. 5) Train stakeholders on the needs assessment during emergencies and conduct the needs assessment. 6) Develop SOPs for emergency response. Strategy 8: Strengthen community preparedness, response, and recovery for natural and man made disasters/outbreaks through national emergency response and recovery strategy. Interventions 1) Review and share the emergency preparedness and response guidelines with county- level Disaster Management Teams. 2) Conduct Nutrition Surveillance in emergency effected counties and districts. 3) Ensure timely provision of emergency response supplies (food and non-food items). 4) Support resilience building in the communities’ emergency response and recovery plans to enhance early recovery. 5) Support pregnant and lactating women with social safety interventions to ensure maternity protections during emergencies. 6) Provide communities with Infection Prevention and Control (IPC) information and materials during emergencies. 60 3 Strategic Objective 3: To shape positively the enabling environment essential for the attainment of positive nutrition outcomes (nutrition policies, guidelines, legislations that influence policies of other sectors to have nutrition lens). Expected outcome: Efficient and Effective Nutrition Legal Frameworks, Guidelines, Standards, and Code of Practice are in place. Strategy 1: Review, update and /or formulate legislation, guidelines, standards, and code of practice on food quality and safety. Interventions 1) Lobby with Legislators to enact food safety and consumer rights laws. 2) Advocate for legislation in the control of marketing of unhealthy foods. 3) Conduct joint visits at the ports of entry to monitor the safety and quality of imported food commodities including infant formula. 4) Conduct quarterly joint visits with MoCI, National Standard Board and Environmental Protection Agency (EPA) at food production, processing, labeling, storage, and handling sites to inspect food commodities and advice on corrective actions to ensure adherence to standards, regulations, and safety. 5) Establish a coordination mechanism for engagement in nutrition legal and regulatory process. 6) Advocacy for development and oversight, monitoring, and enforcement of breastmilk Substitute (BMS). 7) Advocate for workplace support for breastfeeding mothers at both public and private workplaces. 8) Advocate for longer maternity leave (six months) with salary and benefits. 9) Advocate for paternity leave with salary and benefits. Strategy 2: Sensitize and inform the public and key decision makers on the importance of Food Quality and Safety. Interventions 1) Conduct awareness and train relevant nutrition stakeholders to increase the knowledge of consumers on the danger, risks and diseases deriving from the consumption of unsafe foods. 61 Strategy 3: Strengthen institutional capacity to ensure the monitoring and enforcement of Food, Sanitary and Phytosanitary standards. Consumer education, protection and put in place systems for consumers to express grievances and make suggestions for improvement in Food Safety. Interventions 1) Conduct training to strengthen the capacity of institutions and frontline staff on food sanitary and phytosanitary standards. 2) Monitor and institute reporting and feedback mechanism for consumers to report dissatisfaction and recommendations relating to food safety. Strategy 4: Integrate nutrition goals into national development plans, sectoral policies/plans, programs, and projects. Interventions 1) Review all nutrition sensitive key sectors annual programs (agriculture, education, WASH, social welfare, etc. to ensure they reflect sound nutrition sensitive lens. 2) Orientate and train all relevant sectors/stakeholders at all levels to enforce the food and nutrition legal instruments/standards. 3) Negotiate with national authorities to enact laws, develop nutrition policies and guidelines that promote nutrition, food security and safety of food at all levels. 4) Enhance representation of nutrition at other sectoral forums. 5) Support development and progress review of annual workplans and other multi-year plans and policies. 6) Develop and disseminate annual reports. 7) Conduct annual, midterm and end term reviews/evaluations. Strategy 5: Advocate to improve awareness among decision makers on the role of nutrition in national development and how sectors can work together to achieve desirable change. Interventions 1) Engaging the Office of the President for the identification of Nutrition Champion. 2) Scaleup awareness on the importance of nutrition in national development among key political and economic decision makers through forums and presentations at sessions of the House of Representatives and Senate, and all relevant sectors at all levels. 3) Advocate for the ownership and institutionalization of the SUN Secretariat at the highest level in government. 4) Lobby with Law Makers at the highest level to prioritize nutrition in national 62 development plan. 5) Support annual nutrition learning forums. 6) Participate in regional and global international meetings on nutrition. Strategic 6: Advocate for gradual increase of financial allocations for nutrition by the Government. Interventions 1) Advocate for the creation of a budget line for SUN Secretariat and relevant partners. 2) Engage heads of relevant ministries and agencies for the development of budget lines for nutrition. 3) Support to increase multi-sectoral financial investment for nutrition by all stakeholders through roundtables, funding strategies. 4) Regularly advocate for the timely disbursement of funds for nutrition related activities. 5) Conduct high level fund raising for the LMNCSP implementation. 6) Conduct annual donor group forums on nutrition. 7) Develop annual resource mobilization strategy. 8) Conduct nutrition resource tracking at national and county level. 9) Advocate for adequate financial resources for sustained and quality nutrition services including domestic resource mobilization. Strategy 7: Conduct capacity building to strengthen technical capacity for nutrition program implementation, policy analysis, development, and monitoring of their implementation at all Levels. Interventions 1) Conduct capacity strengthening and training of relevant nutrition stakeholders on planning, implementation, and management of nutrition programs. 2) Advocate for human resource development specialty in nutrition at primary, secondary and tertiary levels. 3) Identify knowledge gaps and strengthen human capacity and understanding of nutrition interventions in line with the defined multi-sector institutional arrangement. 4) Conduct pre-service and in-service training for nutrition officers, frontline workers and other cadres of service providers involved in nutrition programming. 5) Advocate for the establishment of a National Nutrition Centre of Excellence 63 4 Strategy 8: Promote Public-Private Partnerships in Nutrition Programming Interventions 1) Promote healthy business network with public-private partnership for nutrition. 2) Link up with relevant ministries to ensure that the private sector live up to their corporate social responsibilities relating to nutrition to save the lives of children. 3) Engage and train private sector companies and communities on nutrition sensitive value chain. 4) Engage in partnerships with private companies involved in food processing to encourage local nutritious food production and fortification of complementary foods. 5) Conduct quality control of fortified foods through regular monitory at all levels of the food value chain. 6) Develop and disseminate framework for enhancing public–private partnership. Strategic Objective 4: To Improve Awareness and Practices of Positive Nutrition Behavior Essential for the Attainment of Optimal Nutrition Status (Demand Creation) Expected outcome: Improved awareness and practices of positive nutrition behavior essential for the attainment of optimal nutrition status (Demand Creation) Strategy 1: Create awareness on appropriate dietary practices and lifestyles essential for the prevention of Noncommunicable Disease and Injury (NCDI) particularly targeting groups most at risk. Interventions 1) Ensure the development and dissemination of Information, Education and Communication (IEC) materials on the prevention and management of Noncommunicable Disease and Injury (NCDI) especially for groups most at risk. 2) Develop guidelines on evidence-based dietary practices essential for the prevention and control of NCDI. 3) Counseling and awareness campaigns on healthy diets, using food-based dietary guidelines, and on the importance of physical activity to prevent overweight, obesity and nutrition related NCDI. 4) Make available nutritional flow chart at all NCDI clinics for patients’ education. 5) Incorporate NCDI related nutrition guidelines in teaching curriculum. 6) Encourage weight monitoring of people most at risks especially in schools and 64 at clinics. 7) Provision of nutrition services in NCDI clinics. 8) Develop/review existing standards and regulations on healthy diets, NCDI and physical activities. 9) Develop behavior change communication strategy on nutrition and NCDI. 10) Develop key messages, advocacy tool kits and sensitize media, journalist, and editors on NCDI. 11) Create public demand for physical activity and healthy diet at workplace, institutions, and community. 12) Advocate for national and district fiscal budgets and prioritization on financing prevention and control of NCDI. Strategy 2: Encourage the Formation of Pressure Groups, such as Anti-smoking, Anti-drug and Anti alcohol Abuse Groups, to enhance capacity to combat the problems. Interventions 1) Support the setting up of peer pressure groups (anti-smoking, anti-alcohol abuse, etc.) in targeted communities. 2) Ensure training of peer educators on NCDI and anti-substance abuse at all levels in the communities. 3) Support the dissemination of the negative effects of smoking, substance abuse, alcohol and their subsequent NCDI via social media, radios, and TV programs to the public. Strategy 3: Develop a Social Behaviour Change Communication Strategy (SBCC) to increase knowledge and promote positive nutrition behavior. Interventions 1) Develop and disseminate Social Behaviour Change Communication Strategy (SBCC) strategy for nutrition. 2) Translate SBCC into various local languages and air via radio to increase knowledge and promote positive nutrition behaviors at all levels. 3) Promote the consumption of diversified local foods at school canteens, workshops, social and official functions. 4) Develop specific nutrition behavioral education and communication plan for key-stakeholders participating in multi-sectors nutrition sensitive programs. 5) Conduct operational research for nutrition. 6) Promote nutritional knowledge and sound behaviour and practices of caregivers 65 towards food, social and dietary customs, family/childcare and feeding practices as well as household hygiene. 7) Adopt SBCC for pre-school, Primary and secondary schools’ children, adolescents in and out of school platforms. Strategy 4: Develop the Capacity of Community and Facility-based Service Providers on essential skills and competencies in nutrition. Interventions 1) Train community and facility-based service providers and community nutrition champions (influential persons) and provide Behaviour Change Communication or Information, Education and Communication (BCC/IEC). 2) Promote nutritional knowledge and sound behaviours and practices of caregivers towards food, social and dietary customs, family/childcare and feeding practices as well as household hygiene. 3) Assess the capacity to identify nutrition knowledge gaps among targeted population to prepare appropriate information on positive behaviour patterns. 4) Strengthen community level structures to implement positive nutrition behaviours. 5) Train community volunteers and entertainers in promotion of nutrition education using the technique of edutainment. Strategy 5: Assign the SUN National Coordinator at an appropriate level/office within Government with convening power. Interventions 1) Scale-up awareness on the importance of nutrition to national development among key political and economic decision makers through forums and presentations at national assemblies and all relevant sessions at all levels. 2) Advocate with the National Legislature, Cabinet Ministers, and especially the Ministry of Finance and Development Planning to place nutrition at the heart of national development. 3) Support the establishment of county and district level coordination mechanisms for Nutrition Specific and Nutrition sensitive intervention. 4) Hold high level sensitization fora targeting policy makers on the value and impact of prioritizing nutrition. 5) Support districts to develop county advocacy, communication, and social mobilization plans. 6) Engage nutrition champions to advocate for prioritization of nutrition at all levels. 7) Advocate for the establishment of County and District Nutrition Officers. Strategy 6: 66 Earmark Regular and Fixed Meeting Dates in Advance. Interventions 1) Conduct annual high level ministerial nutrition meeting to share national progress, updates and increase awareness. 2) Conduct bi-monthly national technical working group meetings (MIYCN), nutrition information, emergency nutrition, and advocacy meetings. 3) Conduct national, county and district level nutrition coordination meetings. 4) Establish Technical Working Group (TWG) when necessary. Strategic Objective 5: To Strengthen Sectoral and Multi-sectoral Monitoring, Evaluation, Learning, Accountability and Research in Nutrition Expected outcome: Formulation and implementation of effective monitoring and evaluation mechanism for policy and decision making for nutrition. Strategy 1: Strengthen existing systems and capacity to collect, analyze, report and monitor nutrition situations to ensure the utilization of data for decision making. Interventions 1) Strengthen the capacity of health care providers and staff of relevant government sectors on the collection, analysis, and utilization of nutrition information. 2) Train all relevant data users on the interpretation of M&E nutrition data. 3) Train M&E officers and decision makers on data management at all levels. 4) Scaleup timely and accurate data on nutrition progress targeting vulnerable populations. 5) Reinforce existing food and nutrition surveillance system for real time monitoring at all levels. 6) Advocate for the conduct of local research on nutrition status of vulnerable groups in country. 7) Support relevant research institutions with equipment, laboratory supplies and technical support to conduct nutrition research. 8) Review and disseminate M&E tools base on new nutrition information. 9) Develop and disseminate quarterly nutrition bulletins. 10) Conduct nutrition situation analysis, generate information products, and disseminate to all levels for planning and response. 11) Support development and review of data protection sharing guidelines. 5 67 12) Develop nutrition dashboards, scorecards, electronic data collection tools, etc. 13) Systematic utilization of nutrition information to inform program quality improvement. Strategy 2: Integrate and Assimilate Standard Nutrition Indicators into Sectoral Information Systems with a priority for Health Management Information System (HMIS). Interventions 1) Define and integrate core Nutrition Indicators in the Health Management Information System (HMIS). 2) Update and maintain national nutrition website. 3) Integrate nutrition sensitive indicators including agriculture, education, WASH, and social protection performance and impact indicators. 4) Review, develop and disseminate guidelines on nutrition M&E based on field learning experi ence and emerging global guidance: Nutrition Coverage Guideline; Data Quality Audit (DQA) Guideline for nutrition indicators; Sentinel Sites DQA Guidelines reviewed; MIYCN Knowledge, Attitude and Practice (KAP) or Knowledge, Practice and Coverage (KPC). 5) Review, develop field assessment manual; MIYCN assessment tools and guidelines; Nutrition HMIS tools review; Standardized Monitoring and Assessment of Relief and Transition (SMART)survey questionnaire review; Knowledge, Attitude and Practice (KAP)survey questionnaire review. 6) Participate in the HMIS indicator manual review. 7) Develop, print, distribute and disseminate nutrition M&E framework, tools, manuals, and guidelines. Strategy 3: Strengthen information systems to ensure the integration, tracking of progress, analysis, and the use of the information for decision-making. Interventions 1) Develop and disseminate quarterly nutrition bulletins. 2) Hold feedback meetings among nutrition stakeholders at all levels; update and maintain national nutrition website. 3) Define and integrate core nutrition indicators in nutrition health management information system (HMIS) and relevant existing platforms. 4) Track progress and challenges of all relevant nutrition specific and nutrition sensitive activities and share on a common platform. 5) Conduct routine nutrition data quality assessments and audits with key sectors. 6) Conduct nutrition data clinics to reflect on Nutrition Information System (NIS) processes, key emerging issues, lessons learned from field implementation and tap into national, regional, and global experts to improve Nutrition Information System (NIS). 7) Conduct data quality audits for Demography Health Information System (DHIS), Logistic Management Information System (LMIS) and sentinel surveillance. 68 8) Review and validate methodologies, results, and quality monitoring during various nutrition surveys. 9) Conduct integrated nutrition SMART surveys, MIYCN, KAP, KPC, and coverage assessment. 10) Map ongoing nutrition research and researchers in Liberia. 11) Integrate nutrition research into the national research strategy. 12) Advocate for local researcher to generate information for nutrition programming. 13) Conduct nutrition data dissemination on a quarterly basis. 14) Conduct an annual national multi-sectoral nutrition conference every two years. 15) Establish and scale up an integrated food and nutrition surveillance system for real time monitoring at all levels. 16) Established a country, county, and district levels website to manage and share nutrition information in the form of a dashboard with key stakeholders. 17) Conduct monthly multi-sectoral nutrition coordination meetings. 18) Conduct routine nutrition data quality assessments and audits with key sectors. 19) Develop a national nutrition resource tracking tool. 20) Hold forums for dissemination of operational research findings and information sharing. 21) Strengthen systematic review of nutrition sensitive and nutrition specific research. 22) Promote knowledge sharing forums such as symposiums and conferences, workshops, meetings. 23) Establish an effective mechanism for knowledge management and learning. 24) Promote knowledge sharing through publication. 69 70 71 MONITORING, EVALUATION, ACCOUNTABILITY, AND LEARNING (MEAL) FRAMEWORK 6 72 6.1 Introduction Monitoring and evaluation will systematically track the progress of suggested interventions, and assess the effectiveness, efficiency, relevance, and sustainability of these interventions. The generated information will inform the implementers, decision makers and various stakeholders as to whether the nutrition programs are on track, and when and where modifications may be needed. It will be critical to have a transparent system of joint periodic data and performance reviews that will involve key multisectoral stakeholders who use the information generated from it. Stakeholders will be encouraged to be aligned with the reporting tools and processes and avoid operating in silos. For ownership and accountability, the nutrition program will maintain an implementation tracking plan which will keep track of review, evaluation, recommendations, and feedback. It is recommended that approximately 10 percent of the program total resource be allotted for M&E, which may include the creation of data collection systems, data analysis software, information dissemination, and M&E coordination. Key details on indicators to be used for monitoring and evaluation are presented under Sub-chapter 8.1, “roles and responsibilities” of the LMNCSP. 6.2 Purpose of the Monitoring, Evaluation, Accountability and Learning (MEAL) Plan The Monitoring, Evaluation, Accountability and Learning (MEAL) plan aims to provide strategic information needed for evidence-based decisions at national and sub-national levels through the development of a Common Results and Accountability Framework (CRAF). The CRAF will form the basis of one common results framework that integrates the information from all sectors related to nutrition, and other non-state actors e.g., private sector, CSOs, NGOs: and external actors such as development partners, technical partners resulting in overall improved efficiency, transparency, and accountability. The current nutrition situation and strategic interventions have been defined in earlier chapters, while the MEAL Plan outlines what indicators to track when, how, and by whom data will be collected. The MEAL Plan will suggest the frequency and timeline for collective program performance reviews with stakeholders. The key indicators that will be used for the evaluation are outlined in Annex A. 6 73 6.3 Monitoring Processes: 6.4 Data Generation Data will be collected from different sources to monitor the progress of implementation. This data will be collected through routine methods such as surveys, sentinel surveillance and periodic assessments, among others. Routine health facility data will be generated using the existing mechanisms monthly. Other routine data, for example, training activity reports, are stored in the nutrition program for reference and consolidation. Data flow from the primary source through the levels of aggregation to the national level will be guided by reporting guidelines and SOPs and reach the national nutrition program by agreed timelines for all levels based on periodicity indicated in Annex A and B. 6.5 Data Validation Data validation will be done through regular data quality assessment to verify the reported progress from source to aggregated values to ensure that data is of the highest quality. Annual and quarterly data quality audits will be carried out to review the data across all the indicators. Joint data validation meetings should be held with membership from key sectors and implementing partners. 6.6 Data analysis This step ensures transformation of data into information which can be used for decision making at all levels. It requires a team with strong analytic skills to make sense of the data. The analysis will be done during the quarterly and annual performance reviews, where achievements will be compared against set targets in the strategic plan. Trend analysis will also be conducted. The output will include quarterly nutrition bulletins and annual nutrition performance review reports. 6.7 Information Dissemination Information products, for example, the quarterly bulletins, annual performance review reports, nutrition fact sheets that are developed will be routinely disseminated to key sector stakeholders and the public. Quarterly and annual reviews and feedback on the progress and plan will be provided. Figure 11: Monitoring Processes Data Generation Data Validation Data Analysis Dissemination Stakeholder Collaboration 74 6.8 Stakeholders Collaboration There are numerous stakeholders mentioned in Annex A, who will play a pivotal role in the monitoring and evaluation of this strategic plan. A joint stakeholder’s engagement and reporting framework will be put in place to guide effective engagement across the stakeholders, including the private sector. The information generated by all these stakeholders is collectively required for the overall assessment of the sector's performance. 6.8.1 Accountability Frameworks The General Audit Commission (GAC) of Liberia has the mandate to ensure that all public funds are accounted for in a transparent manner, upholding integrity, and professionalism. The GAC Act 20141 provides a comprehensive process for the management and audit of all public funds 6.9 Evaluation of the process and criteria To carry out a comprehensive and in-depth evaluation of the strategic plan, clear evaluation questions are to be in place. The proposed evaluation criteria are elaborated below. Relevance: The extent to which the objectives of the Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP) correspond to population needs, including nutrition needs of the vulnerable groups. It also includes an assessment of the responsiveness considering changes and shifts caused by external factors. Effectiveness: The extent to which the 5strategic objectives have been achieved; and the extent to which these objectives have contributed to the achievement of the intended results. Assessing the effectiveness will require a comparison of the intended goals, outcomes, and outputs with the actual achievements in terms of results. Efficiency: The extent to which the LMNCSP objectives have been achieved with the appropriate number of resources. Sustainability: The continuation of benefits from an outlined intervention after its termination. . 24 https://gac.gov.lr 75 76 77 RESOURCE REQUIREMENTS 7 78 The implementation of the LMNCSP requires that all interventions and activities of the strategic objectives are costed. This section describes in detail the level of resource requirements for the strategic plan period, the available resources, and the gap between what is anticipated and what is required. The estimates will help guide and inform the annual planning and budgeting as well as guide the country in the resource mobilization initiatives for both domestic and external sources. 7.1 Resource Requirements for Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP) Financial resources needed for the LMNCSP were estimated by costing all the activities necessary to achieve each of the strategic objectives. The strategic plan is costed using the Activity-Based Costing (ABC) approach. The ABC uses a bottom-up, input-based approach, indicating the cost of all inputs required to achieve strategic plan targets. ABC is a process that allocates costs of inputs based on each activity. It attempts to identify what causes the cost to change (cost drivers). All costs of activities are traced to the product or service for which the activities are performed. The premise of the methodology under the ABC approach will be as follow: (1)The activities require inputs, such as labor, conference hall etc.; (2) The quantities of inputs required and their frequencies; (3) The unit cost of the product, the quantity, and frequency of the input that gave the total cost; (4) The sum of all the input costs will give the activity cost. These were added up to arrive at the strategic objective, intervention, and activity cost, and eventually the resources needed to implement the strategy for the next 5 years. The cost over time for all the strategic objective provides important details that will initiate debate and allow MoH and development partners to discuss priorities and decide on effective resource allocation for Nutrition. 7.2 Summary cost estimates for the Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP). Figure 13 provides summary costs estimates by year. From the costing, USD179 million is required to finance all Interventions of the strategy over the 5 years period. The resources need varies across years with year 1 requiring the highest amount at USD 40Million with year 2 requiring the least at USD34Million. Analysis of the resources requirements shows that 40 percent of the funds will be required for strategic objective 2 to improve the underlying determinants of malnutrition. The multi sectoral nutrition sensitive interventions which complement nutrition specific interventions towards ending all forms of malnutrition will require the largest resources need for the 5 years. Strategic Objective 1 that ensures improved access and utilization of a comprehensive package of proven Direct Nutrition Interventions (DNI) and nutrition-specific interventions will consume the second largest resource need at 39 percent. The lowest resource needed for Strategic Objective 4 to improve awareness and practices of positive nutrition behaviors, is essential for the attainment of optimal nutrition status (demand creation) accounts for 5 percent of resources need for the next 5-year interventions. 7 79 Figure 12: 5-Year Summary Cost for the 5 Strategic Objectives Figure 13: Percentage of Intervention cost by Strategic Objectives Figure 14 shows SO 2 requires 40 percent of Cost followed by SO1 39 percent with SO4 the least with 5percent. Source: ABC Costing 80 Figure 14: Annual Breakdown of Cost the Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP) SOs STRATEGIC OBJECTIVES Cost 2024 (in 000, USD) Cost 2025 (in 000, USD) Cost 2026 (in 000, USD) Cost 2027 (in 000, USD) Cost 2028 (in 000, USD) TOTAL (in 000, USD) Strategic Objective 1: To ensure improvement access to and utilization of a comprehensive package of proven Direct Nutrition Interventions (DNI) and nutrition specific interventions 10,993.62 7,901.18 10,504.77 8,146.61 7,609.20 45,155.38 Strategic Objective 2: To Improve the Underlying Determinants of Malnutrition through multi-sectoral Nutrition Sensitive interventions which compliment Nutrition Specific Interventions towards ending all forms of malnutrition by 40% in 2028. 10,176.23 9,720.20 10,057.80 10,052.92 9,727.98 46,802.13 Strategic Objective 3: To shape positively the enabling environment essential for the attainment of positive nutrition outcomes (nutrition policies, guidelines, laws and legislations, influence policies of other sectors to have nutrition lens) 2,937.40 2,267.00 2,448.70 2,316.10 2,353.20 12,317.30 STRATEGIC OBJECTIVES Cost 2024 (in 000, USD) Cost 2025 (in 000, USD) Cost 2026 (in 000, USD) Cost 2027 (in 000, USD) Cost 2028 (in 000, USD) TOTAL (in 000, USD) Strategic Objective 1: To ensure improvement access to and utilization of a comprehensive package of proven Direct Nutrition Interventions (DNI) and nutrition specific interventions 10,993.62 7,901.18 10,504.77 8,146.61 7,609.20 45,155.38 Strategic Objective 2: To Improve the Underlying Determinants of Malnutrition through multi-sectoral Nutrition Sensitive interventions which compliment Nutrition Specific Interventions towards ending all forms of malnutrition by 40% in 2028. 10,176.23 9,720.20 10,057.80 10,052.92 9,727.98 46,802.13 Strategic Objective 3: To shape positively the enabling environment essential for the attainment of positive nutrition outcomes (nutrition policies, guidelines, laws and legislations, influence policies of other sectors to have nutrition lens) 2,937.40 2,267.00 2,448.70 2,316.10 2,353.20 12,317.30 81 More details on the cost for each on the intervention prioritized in this multi sectoral nutrition strategic plan is presented in Annex B STRATEGIC OBJECTIVES Cost 2024 (in 000, USD) Cost 2025 (in 000, USD) Cost 2026 (in 000, USD) Cost 2027 (in 000, USD) Cost 2028 (in 000, USD) TOTAL (in 000, USD) Strategic Objective 4: To improve awareness and practices of positive nutrition behaviors essential for the attainment of optimal nutrition status (demand creation) 1,772.60 1,108.50 1,140.40 1,136.80 1,995.50 5,754.00 Strategic Objective 5: To strengthen sectoral and multi sectoral monitoring, evaluation, learning, accountability, and research in nutrition 1,614.80 1,329.40 1,412.40 1,391.40 1,466.80 7,214.90 Total for interventions 27,494.65 22,326.28 25,564.07 23,043.83 23,152.68 117,243.71 Figure 15: Cost of Key Priority Areas 82 Strategies to catalyze resources mobilization. Strategies to mobilize resources. • lobbying for a legislative framework at the National Legislature for resource mobilization and allocation. • Identification of potential donors bilateral and multi-lateral. • Conducting stakeholders mapping. • Call the partners to a resource mobilization meeting. • Identification, appointment, and accreditation of eminent persons in the sub region as resource mobilization good-will ambassadors. Strategies to ensure efficiency in resource utilization. • Thorough planning for utilization of the allocated resources. • Implementation plans with timelines. • Continuous monitoring of impact process indicators. • Periodic evaluation of the objectives if they have been achieved as planned. • Ensure that the steering committees are active and delivering on their mandate by supporting their efforts on nutrition financing. 83 Figure 16: LMNSCP Strategy Resource per Line Ministry & Agencies in USD Millions Line Ministry Annual Staff Cost 5 year Interventions Budget Logistics Cost 17% of Budget cost 5 yr. Staff Cost Total project, staff, & Log Cost MoH (Ministry of Health) 719,875.08 45,065,880.00 8,273,093.42 3,599,375.40 56,938,348.82 NPHIL (National Public Health Institute of Liberia) 606,300.00 1,599,100.00 787,202.00 3,031,500.00 5,417,802.00 MoA (Ministry of Agriculture) 1,204,855.56 28,506,130.00 5,870,169.33 6,024,277.80 40,400,577.13 MoE (Ministry of Education) 63,387 5,021,200.00 907,482.95 316,935.00 6,245,617.95 MoCI (Ministry of Commerce and Industry) 815,200.00 2,159,000.00 1,059,950.00 4,076,000.00 7,294,950.00 MoGCSP (Ministry of Gender, Children and Social Protection) 467,594.00 2,159,000.00 764,484.90 2337970 5,261,454.90 MPW (Ministry of Public Works) 1,866,463.95 145,700.00 1,611,263.36 9,332,319.75 11,089,283.11 NaFAA(National Fisheries and Aquaculture Authority) 268,020.00 364,300.00 289,748.00 1,340,100.00 1,994,148.00 MICAT (Ministry of Information, Cultural Affairs and Tourism) 212,880.20 157,200.00 207,672.17 1,064,401.00 1,429,273.17 MFDP (Ministry of Finance and Development Planning) 831,886.00 893,000.00 858,913.10 4,159,430.00 5,911,343.10 NWASHC (National Water, Sanitation & Hygiene Commission 552,108.00 9,677,200.00 2,114,415.80 2,760,540.00 14,552,155.80 SUN Secretariat 55,200.00 18,270,300.00 55,960.00 276,000.00 18,602,260.00 SUN CSAL 75,000.00 3,580,400.00 50,000.00 375,000.00 4,005,400.00 Grand Total 7,738,769.79 117,598,410.00 22,850,355.02 38,693,848.95 179,142,613.97 84 85 INSTITUTIONAL FRAMEWORK 8 86 The Liberia Multi-Sector Nutrition Costed Strategic Plan (LMNCSP) 2024–2028 will be implemented using multi-sectoral approach in line with the National Nutrition Policy 2019 2023. Figure 17 below presents a flowchart of the Liberia Multi-sectoral Nutrition Costed Strategic Plan Institutional Arrangement. Figure 17: Liberia Nutrition Institutional Framework 8 87 8.1 Roles and Responsibilities of the Main Nutrition Stakeholders The Government recognizes the importance of stakeholders and partnership in the implementation of the Liberia Multi-sectoral Nutrition Costed Strategic Plan based on the National Nutrition Policy. The stakeholders include line ministries, departments, agencies, United Nations Agencies, International NGOs, development partners, academic and research institutions, the public sector, and private sectors, CSOs, NGOs, faith-based organizations, and the communities. Their roles are indicated below in the columns “Responsible” of Annex A (Implementation Matrix). SUN National Steering Committee Chairperson (SUN Convener) The functions of the SUN National Nutrition Steering Committee Chairperson and National Convener are: (1). To strengthen the multi-stakeholders’ efforts in developing concrete plans and ensure they are implemented to reduce to minimum prevalence rates all forms of malnutrition in country by 2030;(2). To ensure strong political commitment and accountability measures are in place for nutrition interventions; (3). To ensure sound policy decisions are taken on health and nutrition issues in country; (4). To convene all relevant stakeholders for appropriate actions and information sharing; (5). To coordinate policies and key programs development processes for nutrition; and (6). To support resource mobilization locally, nationally, and internationally for nutrition intervention. Nutrition Champion The roles of a Nutrition Champion are to promote good nutritional awareness and provision of a healthy diet, advocate for nutrition and mobilize communities for nutrition activities. Identify and provide support and solutions for residents with eating and drinking difficulties, ensuring behavior change for healthy and productive lives. Promoting person centered approaches in the provision of good nutritional awareness and uses personal influence on position nutrition as a priority at national and international level to raise awareness, behavior change and promote positive perceptions of nutrition. The SUN Movement Secretariat The SUN Secretariat aim is to strengthen an enabling political environment, with strong in country leadership and coordination, and a shared space where stakeholders align their activities and take joint responsibility for scaling up nutrition in Liberia. The Secretariat is responsible for liaising with the Global SUN Movement and relevant nutrition stakeholders within the Multi-Stakeholder Platform (MSP) to ensure harmonized efforts of all actors to reduce malnutrition in all its forms. SUN Business Network The SUN Business Network focuses on a concomitant enabling and promoting the engagement of small and medium enterprises, large national and multi-national companies to improve nutrition with women involvement. To ensure that the standards in the production 88 and marketing of high nutritious value foods are upheld; follow mandatory fortification requirements and recommended fortification levels in all the centrally processed foods; facilitate the provision and access to improved technology for nutrition promotion; meet their social corporate obligation in promoting good nutrition for their employees and the nation. Civil Society Organizations (CSOs) The Civil Society holds national government, businesses and donors and themselves accountable for their commitment and action in the national nutrition policy. Enhance the capacity and governance of national and local civil society organization through technical support. Boost the advocacy capacity of the network thus bringing the grassroots, community, and national perspective together for decision making. SUN Multi-Stakeholder Platform (SUN MSP) The SUN Multi-Sectoral Platform is a platform established to bring together sector line Ministries & Agencies and all other stakeholders to embrace nutrition sensitive and nutrition specific interventions under one coordinated stage. The SUN MSP will provide technical and sector specific guidance in the implementation of the activities within each sector; provide technical guidance on the implementation of the Liberia Multi-Sectoral Nutrition Costed Strategic Plan (LMNCSP). District/County MSP District/County MSP will work to bring people together, heads of relevant stakeholders in a Multi Stakeholder Platform (MSP) to coordinate in a meeting and provide trainings and awareness at the district levels, provide nutrition technical guidance, monitoring, and evaluation of activities for county and district nutrition stakeholders including community and village level structures to promote nutrition in their areas. Lead in the advocacy for county spending on nutrition in the fiscal year for sustained support to nutrition specific and sensitive programs for nutrition as an integral component in the county development agenda Academic and Research Institutions Academic and research institutions will be responsible for conducting rigorous nutrition research and disseminating findings to inform policy and programming. The academic institutions also play an important role in ensuring that pre-service education building the capacity of professionals from nutrition and cognate sectors (including planning, agriculture, health, economics, research, and academia) to address up-to-date nutrition policies, interventions, and standards. Development Partners Development partners who support nutrition activities will be members of the Multi-Sectoral Platform (MSP) and the relevant government ministries. They will align their nutrition interventions, programs, and financial support with the LMNCSP. The development partners will continue to undertake high-level advocacy for nutrition among policy and decision makers; 89 provide technical, financial support including policy analysis and implementation; and assist government sectors in mobilizing additional resources for nutrition. 8.1.1 Roles of Relevant Line Ministries and Agencies of Government of Liberia (GoL) A. Ministry of Education (MoE) The Ministry of Education (MoE is responsible for development of policies and guidelines for the implementation of the school health, school WASH and nutrition programs, including school feeding, take home rations, promotion, and establishment of schools gardening. It will also ensure that nutrition education is included in school curriculum at all levels of the education system. Key Interventions • Support school feeding to support nutrition and healthy learning environment. • Promote girls school enrolment, including “Girls Take Home Ration.” • Promote IPC practices at all schools. • Provide nutrition education via curriculum, on consumption of micronutrient rich food. • Educate pupils in food production through establishment of school gardening. B. Ministry of Commerce and Industry (MoCI) The Ministry of Commerce and Industry (MoCI) is responsible for enforcement of trade related legislation, Acts, policies that have impact on food, nutrition, including food processing and fortification, e.g. with Vitamin A, Salt Iodization, food standards as defined and protected by the Liberian Standards Board and the Code of Marketing of Breastmilk Substitutes. Key Interventions • To Establish and regulate commodity and trade standards. • Control quality of goods and commodities imported into and exported from the Country. • Monitoring and regulating prices of essential goods. • Support the establishment of small business enterprises, thus encouraging production of local nutrition products which can help in the fight against malnutrition. C. The Ministry of Health (MoH) The Ministry of Health is responsible for oversight, strategic leadership, policy direction, coordination, resource mobilization, capacity building, monitoring, and evaluation of the national nutrition response. The ministry should also be responsible for (1) high level advocacy; (2) spearheading the mainstreaming and integration of nutrition in the national development agenda, sectorial policies, programs, and outreach services; (3) ensuring the implementation of the Health Policies by relevant sectors and other stakeholders based on the defined mandates; (4) tracking sectors performance and ensuring accountability; and (5) resource mobilization and tracking. 90 D. Nutrition Division of MoH The Nutrition Division is responsible for provision of leadership and technical direction in programming and delivery of the quality and cost-effective clinical and biomedical nutrition services in partnership with stakeholders. E. Ministry of Agriculture (MoA) The Ministry of Agriculture is responsible for food and nutrition security and mainstreaming nutrition as a core priority area by focusing on improving food access and promoting diversified diets. The Ministry will support production and consumption of diverse nutritious crops, including bio-fortified foods, and strengthen value chains to improve production, availability, distribution, and access to high-quality and safe nutritious foods. F. National Fisheries and Aquaculture Authority (NaFAA) The National Fisheries and Aquaculture Authority (NaFAA) is a full-fledged autonomous entity established to ensure long tong-term management, conservation, development and sustainable use of the fisheries and aquaculture resources and related ecosystems for the benefit of all population. Fish provides essential nutrients for human health and growth and other forms of livelihood to urban and rural communities. Promotion of fish consumption, fish farming and fish sales can contribute to good nutrition for children and provide means of income generation for rural and urban women. G. Ministry of Gender, Children, and Social Protection (MGCSP) The Ministry of Gender, Children, and Social Protection (MGCSP) is responsible for provision of leadership and technical direction in programming gender and nutrition interventions. The Ministry also promotes women’s empowerment, integration of nutrition in income generation activities, social protection and welfare programs, and community mobilization in support of nutrition. H. National Water, Sanitation and Hygiene Commission (NWASHC) The National Water, Sanitation and Hygiene Commission (NWASHC) is responsible to develop, promote and encourage a national agenda to improve water, sanitation, and hygiene services, including the promotion of Baby WASH interventions in support of nutrition for maternal, infant, child and adolescent among others for the Liberian population. The United Nations Sustainable Development Goal 6 stresses the importance of WASH to nutrition. The main underlying causes of under-nutrition are related to inadequate access to water, sanitation, and hygiene. In Liberia, the NWASHC key interventions include improved access to safe and clean water, increasing improved access to sanitary facilities and materials including latrines, hand washing and hygiene promotion. 91 G. Ministry of Internal Affairs (MIA) The Ministry of Internal Affairs (MIA) is responsible for the implementation of nutrition interventions at the county, district, and community levels. It will ensure that the multi sectoral approach to nutrition is implemented at the county, district, and community levels through the established County-level MSP. It is estimated after discussions with county’s superintendents that about 10 percent of time is allotted to nutrition sensitive activities in the 15 Counties. These include nutrition, health, agriculture, WASH, public works, trade & commerce, gender, and social protections, etc. H. Ministry of Finance and Development Planning (MFDP) The Ministry of Finance and Development Planning (MFDP) will be responsible for mobilization of resources from government, development partners, and private sectors for nutrition intervention. I. Ministry of Information, Cultural Affairs and Tourism (MICAT) The Ministry of Information, Cultural Affairs and Tourism (MICAT) is responsible for dissemination of nutrition information and public awareness in collaboration with MoH and other relevant line ministries. K. Ministry of Public Works (MPW) The Ministry of Public Works (MPW) is responsible for the construction and rehabilitation of roads and bridges linking farms to market, feeder, and major roads from rural communities where food production is carried to major markets in rural cities and urban areas thus creating access and availability of food commodities and cooking fuel in safety to the population. This ministry is also responsible for rural water and sanitation. L. SUN Civil Society Alliance of Liberia (SUNCSAL) The SUN Civil Society Alliance of Liberia (SUNCSAL) is responsible for advocacy and continuous follow-up on government’s adherence to nutrition policies, national and international agreements, and obligations. 92 8.2 Risks and Assumptions (National, County and District Levels) 8.2.1 Risks a) Possibility of insecurity resulting from civil unrest of magnitude large enough to obstruct nutrition interventions. b) Natural or man-made disasters or hazards: Liberia is prone to man-made and natural disasters, epidemics, and pandemics. These include among others, seasonal floods, mudslides, bad roads cutting off part of the country from the capital and major ports of importations of vital communities, cholera, measles, Ebola Virus, and the Corona Virus (COVID-19). These emergencies have a negative impact on the health and nutrition wellbeing of children and women mainly. c) Inadequate funding for nutrition due to economic constraints/ hardship. d) Possibility of reoccurrence of epidemics like Ebola or pandemics like Corona Virus (COVID-19) demanding government to declare state of emergency. e) Limited or inadequate nutrition human resource. f) The amount of national food reserve in case of disaster or hazards to respond to vulnerable population to help keep up their nutrition intake. 8.2.2 Assumptions a) The Government will set nutrition as national development priority. b) Adequate funding budgeted for nutrition by the government or supported by donors and development partners c) The Government will support the implementation and operationalization of this Liberia Multi-sectoral Nutrition Costed Strategic Plan (LMNCSP). d) The enactment of required policies and legislation will be fast tracked to protect and safeguard nutrition in the country. e) The Government and partners will promote capacity building and human resource development for nutrition. f) A multi-sector partnership will be strengthened to highlight nutrition across all relevant sectors. g) The level of awareness will be increased among high-level and all nutrition stakeholders. h) Nutrition will form an essential part of all development interventions at county, district, and community levels. i) Nutrition education will be incorporated in the National Education Curriculum at all levels. j) Nutrition focal persons will be appointed in all relevant government ministries. k) The Government will support the establishment of a National Food Security Response Strategy or Plan to link with the Regional Response Plan. l) The Government will ensure that there is Food Security Emergency Plan – COVID-19 preparedness and response. 93 94 95 REFERENCES 9 96 REFERENCES AAH. (2019). Action Against Hunger - Africa - Liberia. Black et al, R. E. (2013). Maternal and child undernutrition and overweight in low and middle income countries. CEIC. (2020). Liberia - Economic indicators. FAO. (2018). National Gender Profile of Agriculture and Rural Livelihoods – Liberia. Monrovia. GHI. (2020). Liberia - Global Hunger Index. NI. (2018). Nutrition International Programme Gender Equality Strategy. UNDESA. (2020). UN Department of Economic and Social Affairs and the World Population Prospects. Population Division. UNDESA. (2021). UN Department of Economic and Social Affairs and the World Population Prospects. Population Division. UNICEF. (2010). Qualitative Study of IYCF Practices in Liberia. UNICEF. (2017). Progress on drinking water, sanitation and hygiene. UNICEF. (2018). Global Breastfeeding Country Profile of Liberia. UNICEF. (2018). Liberia Demographic and Health Survey 2019-2020. Monrovia, Liberia. UNICEF. (2018). The situation for children in Liberia. UNICEF. (August 2020). Maternal and Newborn Coverage. New York. UNN. (2019). Liberia - The UN Network for SUN. USAID. (June 2018). Liberia Gender Assessment. WFP. (2018). Comprehensive Food Security and Nutrition Survey. WHO. (2020). Word Health Assembly Global Targets 2025. WHO AFRO. (2019). Liberia Country Cooperation Strategy 2018 - 2021. Brazzaville. World Bank. (2020). World Economic Outlook Database. World Bank. (2020). World Economic Outlook Database. 9 97 IM PA CT In di ca to r B as e lin e 20 23 B as el in e D at a So ur ce M id te rm Ta rg et (2 02 5) En d Te rm ta rg et (2 02 7) Re du ce th e pr op or tio n of ch ild re n un de r fiv e w ho a re s tu nt ed to 2 2% G oL P ro po or A ge nd a fo r D ev el op m en t a nd Pr os pe ri ty fo r Li be ri a Pr ev al en ce r at e (% ) o f s tu nt in g in c hi ld re n 0 to 5 9 m on th s of a ge (l ow h ei gh t f or a ge ) 30 % LD H S 20 19 2 02 0 22 % 18 % Re du ce a nd m ai nt ai n ch ild ho od w as tin g to le ss th an 5 % (W H A Ta rg et ) b y 20 25 Pe rc en ta ge o f w as te d ch ild re n un de r fiv e ye ar s (lo w w ei gh t f or h ei gh t). 3% LD H S 20 19 2 02 0 2. 5% 2% Re du ce th e pr op or tio n of ch ild re n w ho a re un de rw ei gh t Pe rc en ta ge o f u nd er w ei gh t u nd er fi ve y ea rs (l ow w ei gh t f or a ge ) 11 % LD H S 20 19 2 02 0 10 % 8% Re du ce th e pr ev al en ce o f ch ild re n w ith a cu te m al nu tr iti on Pr ev al en ce r at e (% ) o f g lo ba l a cu te m al nu tr iti on in in fa nt s le ss th an 6 m on th s 3. 8 % LD H S 20 19 2 02 0 2% 1. 5% Pr ev al en ce r at e (% ) o f g lo ba l a cu te m al nu tr iti on in ch ild re n 6 to 5 9 m on th s of a ge 4% LD H S 20 19 2 02 0 2 % 1% Pr ev al en ce r at e (% ) o f s ev er e ac ut e m al nu tr iti on in ch ild re n le ss th an 6 m on th s of a ge 0. 5% LD H S2 01 9 20 20 0. 25 % 0. 1% Pr ev al en ce r at e (% ) o f s ev er e ac ut e m al nu tr iti on in ch ild re n 6 to 5 9 m on th s of a ge 1% LD H S 20 19 2 02 0 0. 5% 0. 2% Pr ev al en ce r at e (% ) o f m od er at e ac ut e m al nu tr iti on in in fa nt s le ss th an 6 to 5 9 m on th s of a ge 3% LD H S 20 19 2 02 0 2% 1. 5 % 10 STRATEGIC PLAN ANNEXES ANNEX A: Monitoring and Evaluation Matrix Impact indicators 98 IM PA CT In di ca to r B as e lin e 20 23 B as el in e D at a So ur ce M id te rm Ta rg et (2 02 5) En d Te rm ta rg et (2 02 7) Pr ev al en ce r at e (% ) o f m od er at e ac ut e m al nu tr iti on in in fa nt s le ss th an 6 m on th s of a ge 3. 3% LD H S 20 19 2 02 0 2. 3% 1. 5% N o in cr ea se in c hi ld ho od ov er w ei gh t ( ch ild re n un de r 5 ye ar s of ag e) (W H A Ta rg et ) b y 20 25 Pe rc en ta ge o f o ve rw ei gh t o r ob es e ch ild re n le ss th an 5 y ea rs (h ig h w ei gh t f or h ei gh t >2 SD ) 4. 4% G N R 20 21 3. 0% 2. 0% Im pr ov ed s ur vi va l o f ch ild re n b el ow th e ag e of 5 b y 25 % N eo na ta l m or ta lit y ra te 3. 7% LD H S 20 19 2% 1. 0% In fa nt m or ta lit y ra te 6. 3% LD H S 20 19 4% 2% U nd er 5 m or ta lit y ra te 9. 3% LD H S 20 19 7. 3% 4% Re du ct io n of th e bu rd en o f D RN CD s D RN CD s m or ta lit y ra te (1 8 59 y ea rs ) ( pe r 10 0, 00 0) N o da ta W H O N CD Pr og re ss M on ito r Pr ev al en ce o f o ve rw ei gh t a m on g fe m al e ad ul ts 1 8 69 16 .5 % G N R 20 21 12 % 10 % Pr op or tio n of m al e ad ul ts a ge d 18 6 9 ye ar s w ho a re o ve rw ei gh t 6. 7% G N R 20 21 4% 2% Pr op or tio n of fe m al e ad ul ts a ge d 18 6 9 ye ar s w ho a re o be se 20 .7 % G N R 20 21 17 % 10 % Pr op or tio n of m al e ad ul ts a ge d 18 6 9 ye ar s w ho a re o be se 9. 2% G N R 20 21 7% 5% Pr ev al en ce o f H yp er te ns io n am on g w om en (r is in g bl oo d pr es su re ) 28 .1 % G N R 20 21 2 0% 1 0% Ed uc at io na l at ta in m en t o f t he fe m al e ho us eh ol d po pu la tio n im pr ov ed by 4 0% Pe rc en ta ge o f w om en w ho h av e co m pl et ed a t l ea st tw el ve y ea rs o f sc ho ol in g 5% LD H S 20 19 2 02 0 2 0% 3 0% 99 IM PA CT In di ca to r B as e lin e 20 23 B as el in e D at a So ur ce M id te rm Ta rg et (2 02 5) En d Te rm ta rg et (2 02 7) Pr ev al en ce o f i ro n de fic ie nc y an ae m ia in p re gn an t w om en (5 2% re du ct io n by 2 02 5 W H A) 52 % LD H S 20 19 26 % 15 % Re du ce a na em ia in w om en o f re pr od uc tiv e ag e (p re gn an t w om en , ch ild re n, a nd ad ol es ce nt s % O f c hi ld re n un de r 5 ye ar s w ho a re A na em ic 71 % L D H S 20 19 40 % 15 % % O f a do le sc en t g ir ls a ge d 15 1 9 ye ar s w ho a re a na em ic 55 % LD H S 20 19 45 % 35 % Im pr ov ed m ic ro nu tr ie nt co ns um pt io n Pe rc en ta ge o f h ou se ho ld s co ns um in g sa lt w ith a ny io di ne 98 % LD H S 20 19 10 0% 10 0% Vi ta m in A c ov er ag e am on g ch ild re n ag ed b et w ee n 6 59 m on th s at po pu la tio n le ve l 51 % LD H S 20 19 60 % 75 % % O f c hi ld re n un de r 5 ye ar s w ho h av e vi ta m in A d efi ci en cy 53 % LD H S 20 19 2 02 0 30 % 10 % Pr ev al en ce o f Z IN C co ve ra ge a m on g pr es ch oo l c hi ld re n ag ed b el ow 59 m on th s 16 % LD H S 20 19 2 02 0 10 % 5% N ut ri tio ni st d en si ty (N o. o f n ut ri tio ni st s pe r 10 0, 00 0 po pu la tio n) N um be r of n ut ri tio ni st s pe r 10 0, 00 0 po pu la tio n di sa gg re ga te d by s ex N o da ta 100 Output indicators St ra te gi c O bj ec ti ve 1 : To e ns ur e im pr ov ed a cc es s to a nd u ti liz at io n of a c om pr eh en si ve p ac ka ge o f p ro ve n D ir ec t N ut ri ti on In te rv en ti on s (D N I) a nd n ut ri ti on s pe ci fi c in te rv en ti on s St ra te gy 1 : A do pt c om m un ity h ea lth in iti at iv es to r ol l o ut in te gr at ed m an ag em en t o f a cu te m al nu tr iti on a t h ea lth fa ci lit y an d co m m un ity le ve ls O ut pu t: In te gr at ed m an ag em en t o f a cu te m al nu tr iti on (I M AM ) a t h ea lth fa ci lit ie s an d co m m un ity le ve l r ol le d ou t, us in g co m m un ity in iti at iv es O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 % o f S AM o ut pa tie nt s w ho fu lly re co ve re d. 81 % M oH /R H IS 86 % 91 % 96 % 10 0% 10 0% O ut co m e in di ca to rs B as el in e D at a so ur ce 20 23 20 24 20 25 20 26 20 27 # of h ea lth c en te rs in te gr at in g IY CF w ith IM AM & IM N CI 89 0 M oH /R H IS 94 0 99 0 10 40 10 90 11 40 # of h ea lth c en te rs p ro vi di ng IM AM se rv ic es 29 7 M oH /R H IS 33 7 37 7 41 7 45 9 50 0 % o f u nd er 5 s sc re en ed fo r M AM a nd SA M 85 % M oH /R H IS 87 % 89 % 91 % 93 % 95 % # of C H As tr ai ne d in IM AM m an ag em en t 40 03 M oH /R H IS 42 53 45 03 47 53 52 53 55 03 % o f u nd er 5 s sc re en ed fo r SA M a nd M AM 85 % M oH /R H IS 87 % 89 % 91 % 93 % 95 % # of c om m un ity c ar e gi ve rs tr ai ne d in nu tr iti on s en si tiv e in te rv en tio ns p er y ea r 24 4, 27 3 M oH /R H IS /U N IC EF 20 21 75 00 75 00 75 00 80 00 80 00 # of P re gn an t a nd L ac ta tin g w om en w ho be ne fit fr om n ut ri tio n Co un se lin g at he al th c en te rs 21 80 00 M oH /R H IS 22 50 00 23 00 00 23 50 00 24 00 00 25 00 00 101 St ra te gy 2 : In te gr at e cr os s se ct io na l l in ka ge s to e ns ur e th at D N Is a re p ro vi de d ro ut in el y w it hi n th e pu bl ic h ea lt h ca re s ys te m a nd m ai ns tr ea m ed in o th er s ec to rs O ut pu t: D N Is p ro vi de d ro ut in el y w it hi n th e pu bl ic h ea lt hc ar e sy st em t hr ou gh c ro ss s ec ti on al li nk ag es O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 % o f c hi ld re n 6 23 m on th s re ce iv in g th e m in im um a cc ep ta bl e co m pl em en ta ry fo od 3% L D H S 20 19 2 02 0 10 % 20 % 30 % 40 % 50 % % o f c hi ld re n 6 23 m on th s co ns um in g m in im um d ie ta ry d iv er si fie d fo od s 9% LD H S 20 19 2 02 0 15 % 20 % 25 % 30 % 35 % Pr op or tio n of c hi ld re n ag ed 6 2 3 m on th s re ce iv in g an a de qu at e (q ua nt ity an d qu al ity ) d ie t 3% LD H S 20 19 2 02 0 10 % 20 % 30 % 40 % 50 % O ut co m e in di ca to rs B as el in e D at a so ur ce 20 23 20 24 20 25 20 26 20 27 % o f p re gn an t w om en a tt en di ng A N C pr ov id ed w ith IF A 12 % M oH /R H IS 20 % 35 % 50 % 60 % 86 % % o f p re gn an t w om en s ee n at th e AN C, pr ov id ed w ith In se ct ic id e Tr ea te d N et s (IT N S) 5 % d ur in g AN C (8 3% H H fr om M as s di st ri bu tio n) LD H S 20 19 2 02 0 10 % 12 % 13 % 15 % 17 % % o f p re gn an t a nd la ct at in g w om en se en a t t he A N C pr ov id ed w ith n ut ri tio n co un se lin g 59 .3 % L D H S 20 19 2 02 0 65 % 75 % 85 % 95 % 10 0% Pe rc en ta ge o f i nf an ts th at w er e br ea st fe d w ith in o ne h ou r af te r de liv er y 61 % LD H S 20 19 2 02 0 70 % 75 % 80 % 85 % 95 % Pe rc en ta ge o f c hi ld re n 0 6 m on th s ex cl us iv el y br ea st fe d. 55 % LD H S 20 19 2 02 0 60 % 65 % 75 % 80 % 85 % Pe rc en ta ge o f c hi ld re n (1 2 59 m on th s) re ce iv in g de w or m in g m ed ic at io n ev er y 6 m on th s 52 % L D H S 20 19 2 02 0 60 % 65 % 70 % 75 % 80 % Pr op or tio n of s ch oo l-a ge d ch ild re n (6 1 4 ye ar s) d ew or m ed N o da ta 102 O ut co m e in di ca to rs B as el in e D at a so ur ce 20 23 20 24 20 25 20 26 20 27 % o f c hi ld re n (6 1 1 m on th s) r ec ei vi ng Vi ta m in A S up pl em en ta tio n ev er y si x m on th s 43 .9 5% L D H S 20 19 2 02 0 50 % 55 % 60 % 63 % 65 % % o f c hi ld re n (1 2 59 m on th s) re ce iv in g Vi ta m in A S up pl em en ta tio n ev er y si x m on th s 48 .3 % L D H S 20 19 2 02 0 55 % 60 % 65 % 70 % 75 % Pr op or tio n of c hi ld re n un de r 5 at te nd in g CW C w ho a re u nd er w ei gh t N o da ta % o f n ew b or n in th e fa ci lit ie s, w ith lo w b ir th w ei gh t 12 % L D H S 20 19 2 02 0 10 % 8% 6% 5% 4 % Pr op or tio n of c hi ld re n un de r 5 at te nd in g CW C w ho a re s tu nt ed 30 % L D H S 20 19 2 02 0 28 % 26 % 22 % 20 % 1 8% # of c hi ld re n 6 23 m on th s w ho re ce iv e M N P 31 9, 34 5 M oH /N ut ri tio n 12 5, 00 0 31 2, 50 0 31 2, 50 0 62 5, 00 0 70 0, 00 0 W or ld b re as tf ee di ng w ee k ce le br at ed 1 M oH /N ut ri tio n 1 1 1 1 1 # of H ea lth F ac ili tie s im pl em en tin g th e 10 s te ps o f B FH I 9 M oH /N ut ri tio n 8 9 9 9 9 # of H CW s tr ai ne d on m at er na l, ad ol es ce nt , i nf an t a nd y ou ng c hi ld nu tr iti on 22 4, 27 3 M oH / U N IC EF ,2 02 1 25 0, 00 0 27 5, 00 0 30 0, 00 0 32 5, 00 0 35 0, 00 0 103 St ra te gi c O bj ec ti ve 2 : To a dd re ss t he u nd er ly in g de te rm in an ts o f M al nu tr it io n th ro ug h m ul ti s ec to ra l N ut ri ti on S en si ti ve in te rv en ti on s to w ar ds e nd in g al l fo rm s of m al nu tr it io n St ra te gy 1 : I nt eg ra te n ut ri ti on in to W A SH p ol ic ie s, s tr at eg ie s, p la ns a nd p ro gr am m es . O ut pu t: N ut ri ti on in te gr at ed in to W A SH p ol ic ie s, s tr at eg ie s, a nd p la ns O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 % o f c om m un iti es w ith s af e dr in ki ng w at er s up pl y sy st em s an d se rv ic es . 85 % N W AS H C /L IS G IS 87 % 89 % 90 % 95 % 10 0% # of c om m un iti es s en si tiz ed o n lin ka ge s be tw ee n W AS H a nd un de rn ut ri tio n ta rg et in g m en a nd w om en a cr os s di ff er en t a ge s, di ve rs ity , a nd le ve l o f i nfl ue nc e. 28 80 N W AS H C /L IS G IS 35 00 25 00 25 00 27 00 24 50 # of c om m un iti es s en si tiz ed o n en vi ro nm en ta l h yg ie ne p ro m ot io n in pu bl ic a re as a nd d om es tic fa ci lit ie s pe r ye ar 28 80 N W AS H C /L IS G IS 35 00 25 00 25 00 27 00 24 50 St ra te gy 1 : I nt eg ra te n ut ri ti on in to W A SH p ol ic ie s, s tr at eg ie s, p la ns a nd p ro gr am m es . O ut pu t: N ut ri ti on in te gr at ed in to W A SH p ol ic ie s, s tr at eg ie s, a nd p la ns O ut co m e in di ca to rs B as el in e D at a so ur ce 20 23 20 24 20 25 20 26 20 27 # of c om m un ity n ut ri tio n re le va nt st ak eh ol de rs tr ai ne d on ir ri ga tio n te ch ni qu es a nd w at er b an ks / re se rv oi rs . N o da ta # of c om m un iti es in tr od uc ed to b io fo rt ifi ed c ro ps p ro du ct io n N o da ta # of c om m un iti es tr ai ne d on fi sh a nd in se ct fa rm in g pe r ye ar 15 M oA /L IS G IS 24 0 24 0 24 0 24 0 24 0 O ut co m e in di ca to rs B as el in e D at a so ur ce 20 23 20 24 20 25 20 26 20 27 % o f c hi ld re n (6 1 1 m on th s) r ec ei vi ng Vi ta m in A S up pl em en ta tio n ev er y si x m on th s 43 .9 5% L D H S 20 19 2 02 0 50 % 55 % 60 % 63 % 65 % % o f c hi ld re n (1 2 59 m on th s) re ce iv in g Vi ta m in A S up pl em en ta tio n ev er y si x m on th s 48 .3 % L D H S 20 19 2 02 0 55 % 60 % 65 % 70 % 75 % Pr op or tio n of c hi ld re n un de r 5 at te nd in g CW C w ho a re u nd er w ei gh t N o da ta % o f n ew b or n in th e fa ci lit ie s, w ith lo w b ir th w ei gh t 12 % L D H S 20 19 2 02 0 10 % 8% 6% 5% 4 % Pr op or tio n of c hi ld re n un de r 5 at te nd in g CW C w ho a re s tu nt ed 30 % L D H S 20 19 2 02 0 28 % 26 % 22 % 20 % 1 8% # of c hi ld re n 6 23 m on th s w ho re ce iv e M N P 31 9, 34 5 M oH /N ut ri tio n 12 5, 00 0 31 2, 50 0 31 2, 50 0 62 5, 00 0 70 0, 00 0 W or ld b re as tf ee di ng w ee k ce le br at ed 1 M oH /N ut ri tio n 1 1 1 1 1 # of H ea lth F ac ili tie s im pl em en tin g th e 10 s te ps o f B FH I 9 M oH /N ut ri tio n 8 9 9 9 9 # of H CW s tr ai ne d on m at er na l, ad ol es ce nt , i nf an t a nd y ou ng c hi ld nu tr iti on 22 4, 27 3 M oH / U N IC EF ,2 02 1 25 0, 00 0 27 5, 00 0 30 0, 00 0 32 5, 00 0 35 0, 00 0 104 # o f c om m un iti es r ea ri ng ho m es te ad a ni m al s 15 M oA 24 0 25 0 20 0 24 0 24 0 # of fa rm er s su pp lie d w ith h ig h nu tr iti ve v al ue lo ca l s ee ds 15 M oA /L IS G IS 11 10 22 20 0 44 40 55 50 # of s en si tiz at io n se ss io ns c on du ct ed at c om m un ity le ve ls o n co ns um pt io n of a ff or da bl e an d lo ca lly p ro du ce d di ve rs ifi ed n ut ri tio us fo od 11 M oA /L IS G IS 30 30 30 30 30 # of h ou se ho ld s tr ai ne d on ho m es te ad fa rm in g, fo od p ro ce ss in g, fo od p re se rv at io n, fo od s to ra ge N o da ta M oA /L IS G IS St ra te gy 3 : I nt eg ra te n ut ri ti on in to e du ca ti on e nh an ce d nu tr it io n of s ch oo l-g oi ng c hi ld re n an d ad ol es ce nt s O ut pu t: N ut ri ti on in te gr at ed in to t he e du ca ti on s ec to r O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 N ut ri tio n in co rp or at ed in th e sc ho ol cu rr ic ul um N il M oE 0 0 0 1 1 % o f s ch oo ls c on du ct in g co ok in g de m on st ra tio ns to p ro m ot e op tim al nu tr iti ou s fo od a t l ea st o nc e pe r ye ar 30 % M oE 30 % 35 % 40 % 45 % 50 % # of s ch oo ls w ith s ch oo l g ar de ns fo r ag ri cu ltu ra l p ro du ct io n 50 M oE 10 0 15 0 20 0 25 0 30 0 St ra te gy 4 : I nt eg ra te n ut ri ti on in to s oc ia l w el fa re s er vi ce s to p ro vi de a s oc ia l s af et y ne t to v ul ne ra bl e gr ou ps fo r im pr ov ed h ea lt h an d nu tr it io n. O ut pu t: N ut ri ti on in te gr at ed in to t he s oc ia l w el fa re s er vi ce s O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 % o f i de nt ifi ed v ul ne ra bl e ho us eh ol ds p ro vi de d w ith n ut ri tio n se ns iti ve s af et y ne ts N o da ta M oG CS P 105 # of s ta ff tr ai ne d to id en tif y ch ild re n fr om v ul ne ra bl e ho us eh ol ds w ho sh ou ld b en efi t f ro m s oc ia l s af et y ne ts . 38 5 M oG CS P 10 0 10 0 15 0 20 0 20 0 # of s ta ke ho ld er s in s oc ia l p ro te ct io n tr ai ne d on g oo d nu tr iti on p ra ct ic es 38 5 M oG CS P 50 0 50 0 50 0 50 0 50 0 # of v ul ne ra bl e ch ild re n 6 23 m on th s lin ke d w ith s oc ia l s af et y ne ts 45 M oG CS P 10 0 10 0 10 0 10 0 10 0 % o f p oo r ho us eh ol ds w ith p oo r ch ild re n an d ad ol es ce nt s, r ec ei vi ng ca sh tr an sf er s 3, 45 1 M oG CS P 7, 00 0 10 ,4 00 13 ,4 00 16 ,4 00 20 ,0 00 % o f p oo r ho us eh ol ds w ith w om en an d ch ild re n, r ec ei vi ng s pe ci al iz ed fo od tr an sf er s 0 M oG CS P 9, 00 0 11 ,0 00 13 ,0 00 15 ,0 00 17 ,0 00 St ra te gy 5 : E nh an ce a n eff ec ti ve a nd fu nc ti on al in st it ut io na l s ys te m fo r di sa st er r is k m an ag em en t an d em er ge nc y re sp on se O ut pu t: N ut ri ti on m ai nt ai ne d du ri ng d is as te rs /e m er ge nc ie s O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 N ut ri tio n co nt in ge nc y em er ge nc y pl an in p la ce 0 M oH 1 # of s ta ff tr ai ne d on n ut ri tio n su rv ei lla nc e an d re sp on se in em er ge nc ie s 0 M oH 75 75 75 75 10 0 Em er ge nc y co or di na tio n co m m itt ee s in p la ce U nk no w n M oH 15 # of c oo rd in at io n m ee tin gs h el d on em er ge nc y re sp on se U nk no w n M oH 6 6 6 6 6 # of C ou nt ie s w ith e m er ge nc y su pp lie s pr ep os iti on ed U nk no w n M oH # o f c om m un iti es r ea ri ng ho m es te ad a ni m al s 15 M oA 24 0 25 0 20 0 24 0 24 0 # of fa rm er s su pp lie d w ith h ig h nu tr iti ve v al ue lo ca l s ee ds 15 M oA /L IS G IS 11 10 22 20 0 44 40 55 50 # of s en si tiz at io n se ss io ns c on du ct ed at c om m un ity le ve ls o n co ns um pt io n of a ff or da bl e an d lo ca lly p ro du ce d di ve rs ifi ed n ut ri tio us fo od 11 M oA /L IS G IS 30 30 30 30 30 # of h ou se ho ld s tr ai ne d on ho m es te ad fa rm in g, fo od p ro ce ss in g, fo od p re se rv at io n, fo od s to ra ge N o da ta M oA /L IS G IS St ra te gy 3 : I nt eg ra te n ut ri ti on in to e du ca ti on e nh an ce d nu tr it io n of s ch oo l-g oi ng c hi ld re n an d ad ol es ce nt s O ut pu t: N ut ri ti on in te gr at ed in to t he e du ca ti on s ec to r O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 N ut ri tio n in co rp or at ed in th e sc ho ol cu rr ic ul um N il M oE 0 0 0 1 1 % o f s ch oo ls c on du ct in g co ok in g de m on st ra tio ns to p ro m ot e op tim al nu tr iti ou s fo od a t l ea st o nc e pe r ye ar 30 % M oE 30 % 35 % 40 % 45 % 50 % # of s ch oo ls w ith s ch oo l g ar de ns fo r ag ri cu ltu ra l p ro du ct io n 50 M oE 10 0 15 0 20 0 25 0 30 0 St ra te gy 4 : I nt eg ra te n ut ri ti on in to s oc ia l w el fa re s er vi ce s to p ro vi de a s oc ia l s af et y ne t to v ul ne ra bl e gr ou ps fo r im pr ov ed h ea lt h an d nu tr it io n. O ut pu t: N ut ri ti on in te gr at ed in to t he s oc ia l w el fa re s er vi ce s O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 % o f i de nt ifi ed v ul ne ra bl e ho us eh ol ds p ro vi de d w ith n ut ri tio n se ns iti ve s af et y ne ts N o da ta M oG CS P 106 St ra te gi c ob je ct iv e 3: T o sh ap e th e en ab lin g en vi ro nm en t es se nt ia l f or t he a tt ai nm en t of p os it iv e nu tr it io n ou tc om es . St ra te gy 1 : R ev ie w , u pd at e an d /o r fo rm ul at e le gi sl at io n, g ui de lin es , s ta nd ar ds , a nd c od e of p ra ct ic e on fo od q ua lit y an d sa fe ty , a nd nu tr it io n. O ut pu t: U pd at ed r eg ul at io ns , l eg is la ti on , p ol ic ie s an d gu id el in es o n fo od q ua lit y an d sa fe ty O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 Fo od s af et y an d co ns um er r ig ht s la w s in p la ce 1 M oC I 0 0 1 0 0 Le gi sl at io n on m ar ke tin g of un he al th y fo od s in p la ce 1 S U N C SA 1 1 1 1 1 # of la w s/ r eg ul at io ns e na ct ed o n CM BS 1 M oH 1 Pr op or tio n of w or kp la ce s w ith la ct at io n ro om s U nk no w n M oH 10 % 20 % 30 % 40 % 50 % Pr op or tio n of fo od s pr od uc ts , pr oc es se d, la be lle d, a nd s to re d w hi ch M oC I, N at io na l S ta nd ar ds Bo ar d an d EP A co ns id er ed s af e. U nk no w n M oC I # of s ta ke ho ld er s se ns iti ze d on fo od la be lli ng , a nd d an ge rs o f c on su m in g un sa fe fo od s U nk no w n M oC I 50 50 50 50 50 St ra te gy 5 : E nh an ce a n eff ec ti ve a nd fu nc ti on al in st it ut io na l s ys te m fo r di sa st er r is k m an ag em en t an d em er ge nc y re sp on se O ut pu t: N ut ri ti on m ai nt ai ne d du ri ng d is as te rs /e m er ge nc ie s O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of jo in t v is its a nd in sp ec tio ns co nd uc te d at fo od p ro ce ss in g an d la be lli ng b us in es se s. 1 S U N CS A 4 4 4 4 4 107 # of c ou nt ie s w ith n ut ri tio n ad vo ca cy , c om m un ic at io n, a nd s oc ia l m ob ili za tio n pl an s. 6 S U N C SA 3 2 2 1 1 SU N s ec re ta ri at p re m is ed a t t he offi ce o f t he V ic e pr es id en t 0 S U N 1 1 1 1 1 SU N S ub N at io na l o ffi ce s cr ea te d 8 S U N 3 2 1 1 St ra te gy 3 . S tr en gt he n in st it ut io na l c ap ac it y to e ns ur e ad he re nc e to fo od , s an it ar y an d ph yt os an it ar y st an da rd s. O ut pu t: F oo d, s an it ar y an d ph yt os an it ar y st an da rd s en ha nc ed O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of H CW s tr ai ne d on fo od s an ita ry an d ph yt os an ita ry s ta nd ar ds 0 M oH /M oC I 10 0 20 0 20 0 20 0 20 0 # of c ou nt ie s w ith la bs fo r te st in g fo od to e ns ur e nu tr iti on v al ue s ar e m ai nt ai ne d 1 M oC I 3 3 4 2 2 St ra te gy 4 : E nh an ce d nu tr it io n st ak eh ol de r co or di na ti on O ut pu t: N ut ri ti on s ta ke ho ld er s w el l-c oo rd in at ed O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of m ul tis ec to ra l c oo rd in at io n m ee tin gs h el d U nk no w n S U N 12 12 12 12 12 An nu al jo in t p er fo rm an ce r ev ie w m ee tin g on n ut ri tio n, c on du ct ed 0 SU N /R EA CH 1 1 1 1 1 St ra te gy 5 : I nc re as e fi na nc ia l a llo ca ti on s fo r nu tr it io n by t he G ov er nm en t. O ut pu t: In cr ea se d bu dg et ar y al lo ca ti on fo r nu tr it io n O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of m in is tr ie s w ith n ut ri tio n lin e bu dg et 0 Bu dg et ar y al lo ca tio n to n ut ri tio n on a s a pe rc en ta ge o f t ot al h ea lth bu dg et 0% S U N C SA L 3% 6% 9% 12 % 15 % St ra te gi c ob je ct iv e 3: T o sh ap e th e en ab lin g en vi ro nm en t es se nt ia l f or t he a tt ai nm en t of p os it iv e nu tr it io n ou tc om es . St ra te gy 1 : R ev ie w , u pd at e an d /o r fo rm ul at e le gi sl at io n, g ui de lin es , s ta nd ar ds , a nd c od e of p ra ct ic e on fo od q ua lit y an d sa fe ty , a nd nu tr it io n. O ut pu t: U pd at ed r eg ul at io ns , l eg is la ti on , p ol ic ie s an d gu id el in es o n fo od q ua lit y an d sa fe ty O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 Fo od s af et y an d co ns um er r ig ht s la w s in p la ce 1 M oC I 0 0 1 0 0 Le gi sl at io n on m ar ke tin g of un he al th y fo od s in p la ce 1 S U N C SA 1 1 1 1 1 # of la w s/ r eg ul at io ns e na ct ed o n CM BS 1 M oH 1 Pr op or tio n of w or kp la ce s w ith la ct at io n ro om s U nk no w n M oH 10 % 20 % 30 % 40 % 50 % Pr op or tio n of fo od s pr od uc ts , pr oc es se d, la be lle d, a nd s to re d w hi ch M oC I, N at io na l S ta nd ar ds Bo ar d an d EP A co ns id er ed s af e. U nk no w n M oC I # of s ta ke ho ld er s se ns iti ze d on fo od la be lli ng , a nd d an ge rs o f c on su m in g un sa fe fo od s U nk no w n M oC I 50 50 50 50 50 St ra te gy 5 : E nh an ce a n eff ec ti ve a nd fu nc ti on al in st it ut io na l s ys te m fo r di sa st er r is k m an ag em en t an d em er ge nc y re sp on se O ut pu t: N ut ri ti on m ai nt ai ne d du ri ng d is as te rs /e m er ge nc ie s O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of jo in t v is its a nd in sp ec tio ns co nd uc te d at fo od p ro ce ss in g an d la be lli ng b us in es se s. 1 S U N CS A 4 4 4 4 4 108 # of p ar tn er s fu nd in g nu tr iti on in te rv en tio ns 8 S U N 8 10 15 20 20 Re so ur ce m ob ili za tio n st ra te gy in pl ac e 0 S U N 0 1 1 1 1 Re so ur ce tr ac ki ng fo r nu tr iti on d on e 1 S U N C SA L 1 1 1 1 1 St ra te gy 6 : B ui ld t he c ap ac it y fo r nu tr it io n at a ll le ve ls O ut pu t: Im pr ov ed t ec hn ic al c ap ac it y of H CW s on n ut ri ti on O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of m in is tr ie s w ith n ut ri tio n lin e bu dg et 0 Bu dg et ar y al lo ca tio n to n ut ri tio n on a s a pe rc en ta ge o f t ot al h ea lth bu dg et 0% S U N C SA L 3% 6% 9% 12 % 15 % # of p ar tn er s fu nd in g nu tr iti on in te rv en tio ns 8 S U N 8 10 15 20 20 Re so ur ce m ob ili za tio n st ra te gy in pl ac e 0 S U N 0 1 1 1 1 Re so ur ce tr ac ki ng fo r nu tr iti on d on e 1 S U N C SA L 1 1 1 1 1 St ra te gy 6 : B ui ld t he c ap ac it y fo r nu tr it io n at a ll le ve ls O ut pu t: Im pr ov ed t ec hn ic al c ap ac it y of H CW s on n ut ri ti on O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of n ut ri tio ni st s sp ec ia liz ed v ar io us ar ea s, e .g ., on co lo gy , d ia be te s, r en al et c. 6 M oH 12 18 24 27 27 N ut ri tio n ce nt er o f e xc el le nc e in pl ac e 0 S U N 1 2 3 2 2 109 St ra te gy 7 : P ro m ot e Pu bl ic P ri va te P ar tn er sh ip s in n ut ri ti on p ro gr am m in g O ut pu t: E nh an ce d PP P in n ut ri ti on O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of p ri va te in st itu tio ns s up po rt in g nu tr iti on in te rv en tio ns a s CS R 0 S U N 2 3 4 5 5 # of p ub lic p ri va te p ar tn er sh ip es ta bl is he d on n ut ri tio n 0 S U N 5 5 5 5 5 # of p ri va te s ec to r st ak eh ol de rs tr ai ne d on n ut ri tio n se ns iti ve v al ue ch ai n 0 S U N 5 4 3 2 2 St ra te gi c ob je ct iv e 4: T o in cr ea se t he d em an d fo r nu tr it io n se rv ic es t hr ou gh im pr ov ed a w ar en es s St ra te gy 1 : I nc re as e aw ar en es s of n ut ri ti on in N CD p re ve nt io n an d m an ag em en t O ut pu t: Im pr ov ed a w ar en es s on a pp ro pr ia te n ut ri ti on p ra ct ic es t o pr ev en t N CD s O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 # of c am pa ig ns c on du ct ed o n he al th y di et s an d ph ys ic al a ct iv iti es 0 M oH 20 20 40 60 60 # of jo ur na lis ts tr ai ne d on d ie t re la te d N CD m an ag em en t 0 M oH 0 10 15 20 25 St ra te gy 2 : I m pr ov e th e be ha vi ou r ch an ge fo r po si ti ve n ut ri ti on o ut co m es . O ut pu t: Im pr ov ed k no w le dg e, a tt it ud e, a nd p ra ct ic e of p os it iv e nu tr it io n ha bi ts O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 SB C st ra te gy fo r nu tr iti on d ev el op ed 0 M oH 1 St ra te gy 3 : S tr en gt he n co m m un it y nu tr it io n in te rv en ti on s O ut pu t: Im pr ov ed k no w le dg e, a tt it ud e, a nd p ra ct ic e of p os it iv e nu tr it io n ha bi ts O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 Pr op or tio n of p op ul at io n co ns um in g di ve rs ifi ed lo ca l f oo ds un kn ow n M oH 50 % 60 % 70 % 75 % 80 % # of p ar tn er s fu nd in g nu tr iti on in te rv en tio ns 8 S U N 8 10 15 20 20 Re so ur ce m ob ili za tio n st ra te gy in pl ac e 0 S U N 0 1 1 1 1 Re so ur ce tr ac ki ng fo r nu tr iti on d on e 1 S U N C SA L 1 1 1 1 1 St ra te gy 6 : B ui ld t he c ap ac it y fo r nu tr it io n at a ll le ve ls O ut pu t: Im pr ov ed t ec hn ic al c ap ac it y of H CW s on n ut ri ti on O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of m in is tr ie s w ith n ut ri tio n lin e bu dg et 0 Bu dg et ar y al lo ca tio n to n ut ri tio n on a s a pe rc en ta ge o f t ot al h ea lth bu dg et 0% S U N C SA L 3% 6% 9% 12 % 15 % # of p ar tn er s fu nd in g nu tr iti on in te rv en tio ns 8 S U N 8 10 15 20 20 Re so ur ce m ob ili za tio n st ra te gy in pl ac e 0 S U N 0 1 1 1 1 Re so ur ce tr ac ki ng fo r nu tr iti on d on e 1 S U N C SA L 1 1 1 1 1 St ra te gy 6 : B ui ld t he c ap ac it y fo r nu tr it io n at a ll le ve ls O ut pu t: Im pr ov ed t ec hn ic al c ap ac it y of H CW s on n ut ri ti on O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of n ut ri tio ni st s sp ec ia liz ed v ar io us ar ea s, e .g ., on co lo gy , d ia be te s, r en al et c. 6 M oH 12 18 24 27 27 N ut ri tio n ce nt er o f e xc el le nc e in pl ac e 0 S U N 1 2 3 2 2 110 St ra te gi c O bj ec ti ve 5 : T o st re ng th en s ec to ra l a nd m ul ti s ec to ra l m on it or in g, e va lu at io n, le ar ni ng , a cc ou nt ab ili ty , a nd r es ea rc h in nu tr it io n St ra te gy 1 . T o st re ng th en s ec to ra l a nd m ul ti s ec to ra l m on it or in g, e va lu at io n, le ar ni ng , a cc ou nt ab ili ty , a nd r es ea rc h in n ut ri ti on O ut pu t: E nh an ce d sy st em s fo r co lle ct io n, a na ly si s, r ep or ti ng /m on it or in g of n ut ri ti on in te rv en ti on s an d ou tc om es O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 # of n ut ri tio n st aff tr ai ne d on an al ys is a nd in te rp re ta tio n of nu tr iti on d at a 1 M oH 5 10 15 20 25 # of d at a co lle ct io n to ol s fo r nu tr iti on re vi ew ed N o D at a # of M in is tr ie s w ith n ut ri tio n se ns iti ve in di ca to rs in te gr at ed in th e H M IS 2 M oH 4 6 10 12 20 N o D at a N o D at a # of n ut ri tio n da sh bo ar ds d ev el op ed 0 M oH 1 1 1 1 1 St ra te gy 2 : S tr en gt he n sy st em s fo r di ss em in at io n an d us e of n ut ri ti on d at a. O ut pu t: N ut ri ti on d at a/ in fo rm at io n di ss em in at ed t o va ri ou s st ak eh ol de rs O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of o pe ra tio na l r es ea rc h co nd uc te d on n ut ri tio n pe r ye ar 0 S U N 0 1 0 1 0 # of n ut ri tio n re la te d pu bl ic at io ns pe r ye ar 0 S U N 2 3 4 5 6 # of n ut ri tio n bu lle tin s de ve lo pe d pe r ye ar 0 S U N 12 12 12 12 12 # of n ut ri tio n kn ow le dg e sh ar in g fo ru m s co nd uc te d pe r ye ar 0 S U N 2 2 2 2 2 111 # of n ut ri tio n m ul tis ta ke ho ld er co nf er en ce s co nd uc te d pe r ye ar 2 S U N 1 1 1 1 1 # of n ut ri tio n in fo rm at io n sy st em gu id el in es r ev ie w ed /d ev el op ed 0 S U N 2 0 2 0 2 St ra te gy 3 : S tr en gt he n in fo rm at io n sy st em s to e ns ur e th e in te gr at io n, t ra ck in g of p ro gr es s, a na ly si s, a nd t he u se o f t he in fo rm at io n fo r de ci si on m ak in g Im pr ov ed q ua lit y of n ut ri ti on in fo rm at io n fo r de ci si on m ak in g O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of d at a qu al ity a ss es sm en ts co nd uc te d on n ut ri tio n da ta 4 M oH 4 4 4 4 4 St ra te gi c O bj ec ti ve 5 : T o st re ng th en s ec to ra l a nd m ul ti s ec to ra l m on it or in g, e va lu at io n, le ar ni ng , a cc ou nt ab ili ty , a nd r es ea rc h in nu tr it io n St ra te gy 1 . T o st re ng th en s ec to ra l a nd m ul ti s ec to ra l m on it or in g, e va lu at io n, le ar ni ng , a cc ou nt ab ili ty , a nd r es ea rc h in n ut ri ti on O ut pu t: E nh an ce d sy st em s fo r co lle ct io n, a na ly si s, r ep or ti ng /m on it or in g of n ut ri ti on in te rv en ti on s an d ou tc om es O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 20 25 20 26 20 27 20 28 # of n ut ri tio n st aff tr ai ne d on an al ys is a nd in te rp re ta tio n of nu tr iti on d at a 1 M oH 5 10 15 20 25 # of d at a co lle ct io n to ol s fo r nu tr iti on re vi ew ed N o D at a # of M in is tr ie s w ith n ut ri tio n se ns iti ve in di ca to rs in te gr at ed in th e H M IS 2 M oH 4 6 10 12 20 N o D at a N o D at a # of n ut ri tio n da sh bo ar ds d ev el op ed 0 M oH 1 1 1 1 1 St ra te gy 2 : S tr en gt he n sy st em s fo r di ss em in at io n an d us e of n ut ri ti on d at a. O ut pu t: N ut ri ti on d at a/ in fo rm at io n di ss em in at ed t o va ri ou s st ak eh ol de rs O ut co m e in di ca to rs B as el in e D at a so ur ce 20 24 2 02 5 20 26 20 27 20 28 # of o pe ra tio na l r es ea rc h co nd uc te d on n ut ri tio n pe r ye ar 0 S U N 0 1 0 1 0 # of n ut ri tio n re la te d pu bl ic at io ns pe r ye ar 0 S U N 2 3 4 5 6 # of n ut ri tio n bu lle tin s de ve lo pe d pe r ye ar 0 S U N 12 12 12 12 12 # of n ut ri tio n kn ow le dg e sh ar in g fo ru m s co nd uc te d pe r ye ar 0 S U N 2 2 2 2 2 112 ANNEX B: Implementation Matrix The implementation matrix consists of the strategic objectives, strategies, and prioritized interventions in the MSN plan. This section shows the resources need which are indicated in the expected year of intervention implementation. In addition, the responsible entity and supporting entities drawn from multisectoral stakeholders, relevant line ministries and agencies are also indicated. LI B ER IA M U LT I-S EC O TR A L N U N TR IT IO N C O ST ED S TR A TE G IC PL A N T O TA LI N TE RV EN TI O N S CO ST F O R 5 YE A RS Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 00 0, U SD ) O VE RA LL T O TA L 26 ,9 82 .1 5 22 ,3 73 .7 8 25 ,6 11 .6 1 23 ,1 31 .3 3 22 ,4 32 .6 7 11 7, 59 3. 70 In te rv en ti on s M oH Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 00 0, U SD ) St ra te gi c O bj ec tiv e 1: T o en su re im pr ov em en t a cc es s to a nd u til iz at io n of a co m pr eh en si ve pa ck ag e of p ro ve n D ir ec t N ut ri tio n In te rv en tio ns (D N I) an d nu tr iti on s pe ci fic in te rv en tio ns M oH 10 ,9 72 .0 2 7, 87 9. 08 10 ,4 82 .1 7 8, 12 3. 41 7, 60 9. 20 45 ,0 65 .8 8 St ra te gy 1 : Ad op t co m m un ity h ea lth in iti at iv es to r ol l ou t i nt eg ra te d m an ag em en t o f ac ut e m al nu tr iti on nu tr iti on a t h ea lth fa ci lit ie s an d co m m un ity le ve ls 6, 16 7. 63 3, 38 6. 92 5, 87 7. 15 3, 28 1. 91 3, 25 5. 25 21 ,9 68 .8 6 1. P ro cu re a nd di st ri bu te In te gr at ed M an ag em en t o f Ac ut e M al nu tr iti on (IM AM ) s up pl ie s an d eq ui pm en t, in cl ud in g ou tr ea ch an d O PT M oH U N IC EF , W H O , an d ot he r re le va nt st ak eh ol de rs 3, 11 0. 53 113 2. In te gr at e M IY CF w ith IM AM , a nd IM N CI (I nt eg ra te d M an ag em en t o f N eo na ta l a nd C hi ld ho od Il ln es se s) pa ck ag e an d se rv ic es (S oc ia l S er vi ce s an d liv el ih oo d) a s pr ev en tio n st ra te gi es at c om m un ity a nd h ou se ho ld le ve l M oH W H O , U N IC EF , M oG CS P an d ot he r re le va nt st ak eh ol de rs 28 .8 0 0 0 0 28 .8 3. C on du ct m as s sc re en in g an d ro ut in e sc re en in g of u nd er 5 to fa ci lit at e th e id en tifi ca tio n of in di vi du al s w ith S ev er e or M od er at e Ac ut e M al nu tr iti on (M AM ) an d re fe r ap pr op ri at el y M oH U N IC EF , A AH , Co nc er n, L M H , an d ot he r re le va nt IN G O s 2, 80 6. 00 33 8. 6 2, 86 7. 20 35 4. 3 36 2. 5 6, 72 8. 60 4. D is se m in at e IM AM tr ai ni ng p ac ka ge fo r he al th w or ke rs M oH U N IC EF , W H O an d ot he r re le va nt IN G O s 17 1. 9 0 0 0 0 17 1. 9 5. D ev el op a c os te d sc al ed u p pl an to e xp an d ac ce ss to M AM tr ea tm en t w ith in th e co un tr y M oH U N IC EF , W H O an d ot he r re le va nt IN G O s 28 .8 0 0 0 0 28 .8 LI B ER IA M U LT I-S EC O TR A L N U N TR IT IO N C O ST ED S TR A TE G IC PL A N T O TA LI N TE RV EN TI O N S CO ST F O R 5 YE A RS Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 00 0, U SD ) O VE RA LL T O TA L 26 ,9 82 .1 5 22 ,3 73 .7 8 25 ,6 11 .6 1 23 ,1 31 .3 3 22 ,4 32 .6 7 11 7, 59 3. 70 In te rv en ti on s M oH Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 00 0, U SD ) St ra te gi c O bj ec tiv e 1: T o en su re im pr ov em en t a cc es s to a nd u til iz at io n of a co m pr eh en si ve pa ck ag e of p ro ve n D ir ec t N ut ri tio n In te rv en tio ns (D N I) an d nu tr iti on s pe ci fic in te rv en tio ns M oH 10 ,9 72 .0 2 7, 87 9. 08 10 ,4 82 .1 7 8, 12 3. 41 7, 60 9. 20 45 ,0 65 .8 8 St ra te gy 1 : Ad op t co m m un ity h ea lth in iti at iv es to r ol l ou t i nt eg ra te d m an ag em en t o f ac ut e m al nu tr iti on nu tr iti on a t h ea lth fa ci lit ie s an d co m m un ity le ve ls 6, 16 7. 63 3, 38 6. 92 5, 87 7. 15 3, 28 1. 91 3, 25 5. 25 21 ,9 68 .8 6 1. P ro cu re a nd di st ri bu te In te gr at ed M an ag em en t o f Ac ut e M al nu tr iti on (IM AM ) s up pl ie s an d eq ui pm en t, in cl ud in g ou tr ea ch an d O PT M oH U N IC EF , W H O , an d ot he r re le va nt st ak eh ol de rs 3, 11 0. 53 114 St ra te gy 2 : In te gr at e cr os s se ct or al lin ka ge s to e ns ur e th at D N Is a re pr ov id ed r ou tin el y w ith in th e pu bl ic he al th c ar e sy st em a nd m ai ns tr ea m ed in ot he r se ct or s (P ro m ot io n of a do le sc en t an d pr e co nc ep tio n nu tr iti on ; I ro n fo lic s up pl em en ta tio n fo r pr eg na nt w om en ; I YC F: P ro m ot io n of o pt im al br ea st fe ed in g, M ul ti m ic ro nu tr ie nt (M N P) s up pl em en ta tio n fo r ch ild re n ag ed 6 2 3 m on th s, ) 4, 80 4. 39 4, 49 2. 16 4, 60 5. 02 4, 84 1. 51 4, 35 3. 94 23 ,0 97 .0 2 1. D ev el op a nd d is se m in at e a na tio na l s tr at eg y fo r ad ol es ce nt a nd pr ec on ce pt io n nu tr iti on . M oH U N IC EF , N PH IL , L M H , AA H , C on ce rn , W FP /R EA CH , W H O , I ri sh Ai d an d ot he r re le va nt st ak eh ol de rs 20 0. 7 0 0 0 0 20 0. 7 2. C on du ct a w ar en es s ca m pa ig ns o n th e im po rt an ce o f a do le sc en ts ’ n ut ri tio n, H IV /A ID S, R ep ro du ct iv e H ea lth , a nd W AS H u si ng v ar io us c ha nn el s. M oH U N IC EF , N PH IL , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , W at er Ai d, Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 12 6. 9 12 9. 8 13 2. 8 13 5. 9 13 9 66 4. 4 3. P ro vi de IF A (Ir on F ol ic A ci d su pp le m en t t o pr eg na nt w om en a t An te na ta l C ar e (A N C) fo r 18 0 da ys . M oH U N IC EF , N PH IL , L M H , AA H , C on ce rn , W FP /R EA CH , W H O , I ri sh Ai d, a nd o th er re le va nt st ak eh ol de rs 1, 71 7. 35 1, 76 0. 28 1, 78 9. 37 1, 83 4. 11 1, 84 9. 39 8, 95 0. 50 115 4. P ro vi de p re gn an t w om en w ith In se ct ic id e –T re at ed N et s (IT N s) to pr ev en t m al ar ia . M oH U N IC EF , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 0 0 0 0 0 0 7. P ro vi de n ut ri tio n co un se lin g fo r PL W an d ot he r ca re g iv er s M oH U N IC EF , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , Ir is h Ai d an d ot he r re le va nt st ak eh ol de rs 0 0 0 0 0 0 8. P ro m ot e at te nd an ce to a nt en at al a nd po st na ta l c lin ic s by P LW s M oH U N IC EF , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , Ir is h Ai d an d ot he r re le va nt st ak eh ol de rs 41 .3 42 .3 43 .3 44 .3 45 .3 21 6. 4 9. E nc ou ra ge , m on ito r, a nd d oc um en t m ot he rs w ho in iti at e br ea st fe ed in g of ch ild re n w ith in th e fir st o ne h ou r of b ir th M oH U N IC EF , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 15 .7 16 16 .4 16 .8 17 .2 82 .1 10 . P ro m ot e, p ro te ct , a nd s up po rt ex cl us iv e br ea st fe ed in g fo r ch ild re n 0 6 m on th s M oH U N IC EF , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 1, 16 8. 70 1, 19 5. 60 1, 22 3. 10 1, 25 1. 20 1, 28 0. 00 6, 11 8. 60 St ra te gy 2 : In te gr at e cr os s se ct or al lin ka ge s to e ns ur e th at D N Is a re pr ov id ed r ou tin el y w ith in th e pu bl ic he al th c ar e sy st em a nd m ai ns tr ea m ed in ot he r se ct or s (P ro m ot io n of a do le sc en t an d pr e co nc ep tio n nu tr iti on ; I ro n fo lic s up pl em en ta tio n fo r pr eg na nt w om en ; I YC F: P ro m ot io n of o pt im al br ea st fe ed in g, M ul ti m ic ro nu tr ie nt (M N P) s up pl em en ta tio n fo r ch ild re n ag ed 6 2 3 m on th s, ) 4, 80 4. 39 4, 49 2. 16 4, 60 5. 02 4, 84 1. 51 4, 35 3. 94 23 ,0 97 .0 2 1. D ev el op a nd d is se m in at e a na tio na l s tr at eg y fo r ad ol es ce nt a nd pr ec on ce pt io n nu tr iti on . M oH U N IC EF , N PH IL , L M H , AA H , C on ce rn , W FP /R EA CH , W H O , I ri sh Ai d an d ot he r re le va nt st ak eh ol de rs 20 0. 7 0 0 0 0 20 0. 7 2. C on du ct a w ar en es s ca m pa ig ns o n th e im po rt an ce o f a do le sc en ts ’ n ut ri tio n, H IV /A ID S, R ep ro du ct iv e H ea lth , a nd W AS H u si ng v ar io us c ha nn el s. M oH U N IC EF , N PH IL , LM H , A AH , Co nc er n, W FP / RE AC H , W H O , W at er Ai d, Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 12 6. 9 12 9. 8 13 2. 8 13 5. 9 13 9 66 4. 4 3. P ro vi de IF A (Ir on F ol ic A ci d su pp le m en t t o pr eg na nt w om en a t An te na ta l C ar e (A N C) fo r 18 0 da ys . M oH U N IC EF , N PH IL , L M H , AA H , C on ce rn , W FP /R EA CH , W H O , I ri sh Ai d, a nd o th er re le va nt st ak eh ol de rs 1, 71 7. 35 1, 76 0. 28 1, 78 9. 37 1, 83 4. 11 1, 84 9. 39 8, 95 0. 50 116 11 . E st ab lis h m ec ha ni sm s to c ol la bo ra te w ith p ri nt a nd e le ct ro ni c m ed ia to sc al e up m at er na l a do le sc en t, in fa nt an d yo un g ch ild n ut ri tio n pr ac tic es m es sa gi ng M oH U N IC EF , M IC A, RE AC H , a nd ot he r re le va nt st ak eh ol de rs 29 .1 29 .8 30 .5 31 .2 31 .9 15 2. 6 12 . P ro m ot e ce le br at io n of W or ld Br ea st fe ed in g W ee k an d ot he r M AI YC N (M at er na l, Ad ol es ce nt , I nf an t a nd Y ou ng Ch ild N ut ri tio n) g lo ba l/n at io na l e ve nt s M oH U N IC EF , S U N CS O , W H O , RE AC H a nd ot he r re le va nt st ak eh ol de rs 39 .5 40 .4 41 .4 42 .3 43 .3 20 7 13 . D ev el op a nd tr ai n he al th w or ke rs an d co m m un ity a ss is ta nt s an d (C H Vs ) Co m m un ity h ea lth v ol un te er s on m at er na l, ad ol es ce nt , i nf an t a nd y ou ng ch ild n ut ri tio n pr ac tic es p ac ka ge s M oH U N IC EF , S U N CS O , R EA CH , an d ot he r re le va nt st ak eh ol de rs 77 3. 2 79 1 80 9. 2 82 7. 8 42 3. 4 3, 62 4. 50 14 . C hi ld g ro w th m on ito ri ng to ol s (M U AC , w ei gh in g sc al es , h ei gh t bo ar di es t f or 1 54 h ea lth fa ci lit ie s) M oH U N IC EF , S U N CS O , R EA CH , an d ot he r re le va nt st ak eh ol de rs 15 3. 20 4 0 0 15 3. 20 4 0 30 6. 41 15 . P ro vi de d ew or m in g fo r ad ol es ce nt s (1 x y ea r) M oH U N IC EF , SU N C SO , RE AC H ,M oE an d ot he r re le va nt st ak eh ol de rs 16 2. 98 2 16 7. 05 5 17 1. 23 1 17 5. 51 2 17 9. 9 85 6. 68 16 . A du lts w ei gh t M on ito ri ng M AU C M oH U N IC EF , S U N CS O , R EA CH , an d ot he r re le va nt st ak eh ol de rs 1. 23 8 0 0 1. 25 8 0 2. 50 117 18 . I ns tit ut io na liz e th e 10 s te ps to su cc es sf ul b re as tf ee di ng in a ll he al th fa ci lit ie s th at p ro vi de m at er ni ty s er vi ce s vi a Ba by F ri en dl y H os pi ta l I ni tia tiv es . (N ow in 6 c ou nt ie s) M oH U N IC EF , W H O a nd ot he r re le va nt st ak eh ol de rs 0 0 19 .8 0 0 19 .8 19 . D ev el op N at io na l F oo d Co m po si tio n Ta bl e an d D ie ta ry R ef er en ce In ta ke M oH U N IC EF , W H O a nd ot he r re le va nt st ak eh ol de rs 62 .4 0 0 0 0 6 2. 4 118 119 4. E st ab lis hm en t o f f ar m er s fie ld sc ho ol s, s ee d ba nk s an d co m m un ity se ed a nd fr ui t n ur se ri es M oA F AO , W FP , W H H , C on ce rn an d ot he r re le va nt st ak eh ol de rs 20 0. 35 20 0 14 0 75 75 69 0. 35 5. In tr od uc e bi o fo rt ifi ed fo od c ro ps va ri et ie s to s up po rt h ea lth y di et s. M oA F AO , W FP , W H H , C on ce rn an d ot he r re le va nt st ak eh ol de rs 14 0 14 0 80 50 50 46 0 6. P ro m ot e an d pr ot ec t h om es te ad an im al r ea ri ng to p ro du ce a ni m al so ur ce fo od in s up po rt o f h ea lth y di et . M oA F AO , W FP , W H H , Z O A, Co nc er n, a nd ot he r re le va nt st ak eh ol de rs 11 5. 16 11 5. 16 11 5. 16 11 5 11 5. 16 57 5. 8 7. A dv oc at e w ith M in is tr ie s of Ag ri cu ltu re /p ar tn er s fo r th e di st ri bu tio n of h ig h nu tr iti ve v al ue lo ca l s ee ds , a ni m al s, a nd fi sh er ie s to vu ln er ab le h ou se ho ld s. M oA F AO , W H H , Co nc er n, Z O A an d o th er re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 8. E du ca te c om m un iti es o n nu tr iti on qu al iti es o f f oo ds th at a re lo ca lly av ai la bl e, c ul tu ra lly a cc ep ta bl e, a nd lo w c os t t o en ab le th em to m ak e in fo rm ed d ec is io ns w he n pu rc ha si ng at lo ca l m ar ke ts ) M oA (L ea d) , M oH , M oE F AO , Z O A, Co nc er n, A AH , W H H , a nd ot he r re le va nt st ak eh ol de rs 76 .1 77 .8 79 .6 81 .4 83 .3 39 8. 2 9. P ro m ot io n of y ea r ro un d pr od uc tio n of fr ui ts a nd v eg et ab le ga rd en s fo r he al th y di et s. M oA F AO , W H H , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 13 3. 6 13 6. 6 13 9. 8 14 3 14 6. 3 69 9. 3 10 . T ra in c ar e gr ou ps a nd ho us eh ol ds o n ho m es te ad fa rm in g, fo od p ro ce ss in g, a nd p re se rv at io n, st or ag e, a nd u til iz at io n of d iv er si fie d fo od s fo r im pr ov ed n ut ri tio n st at us . M oA (l ea d) M oH F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 63 5. 4 65 0 66 4. 9 68 0. 2 69 5. 9 3, 32 6. 30 120 11 . E ns ur e th e es ta bl is hm en t o f se ed m ul tip lic at io n ga rd en s an d re la te d ag ri cu ltu re in pu ts a t t he co m m un ity le ve l M oA F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 21 0 21 4. 8 21 9. 8 22 4. 8 23 0 1, 09 9. 40 12 . T im el y di st ri bu tio n of a gr ic ul tu re in pu ts to fa rm er s al on g w ith v ia bl e se ed s M oA F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 74 1. 28 74 1. 28 74 1. 28 74 1. 28 74 1. 28 3, 70 6. 40 13 . E nc ou ra ge a ni m al fa rm er s to m on ito r an im al ’s bi os af et y an d bi o se cu ri ty m ea su re s to k ee p di se as es ou t o f t he fa rm . M oA F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 82 82 82 82 82 41 0 14 . E st ab lis h ye ar ly c ro ps s ur ve y of th e pr od uc tio n du ri ng h ar ve st to en ab le e st im at e fo r le an s ea so n M oA F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 48 5. 37 5 48 5. 37 5 48 5. 37 5 48 5. 37 5 48 5. 37 5 2, 42 6. 88 15 . E st ab lis h a m on th ly m ar ke t pr ic e m on ito ri ng to g en er at e pr ic e bu lle tin o f m aj or fo od c om m od iti es M oA F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 46 8 46 8 46 8 46 8 46 0 2, 34 0. 00 121 In te rv en ti on s M oE Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 00 0, U SD ) M oE T ot al s 1, 05 0. 27 85 2. 49 1, 04 8. 02 94 4. 56 1, 12 6. 06 5, 02 1. 20 S. O . 2 : S tr at eg y 3: D ev el op a Pa ck ag e of N ut ri tio n an d Ad ol es ce nt Se xu al a nd R ep ro du ct iv e he al th In te rv en tio ns a nd O pe ra tio na l G ui de lin es A pp ro pr ia te fo r Sc ho ol go in g Ch ild re n an d Ad ol es ce nt s 98 3. 07 79 7. 89 99 2. 22 88 7. 36 1, 06 7. 56 4, 72 7. 90 1. S up po rt th e de ve lo pm en t o f sc ho ol n ut ri tio n cu rr ic ul um . M oE U N IC EF , W FP , FA O , a nd ot he r re le va nt st ak eh ol de rs 86 .4 0 0 0 0 86 .4 2. S up po rt s ch oo l f ee di ng to pr om ot e nu tr iti on a nd h ea lth y le ar ni ng e nv ir on m en t M oE (L ea d) , M oH W FP , U N IC EF , an d ot he r re le va nt st ak eh ol de rs 46 .7 47 .8 48 .9 50 51 .1 24 4. 4 3. E na bl e re le va nt s ec to rs co m m un ity s ta ke ho ld er s to p ro vi de su pp or t a nd g ui da nc e w ith in s ch oo ls re ga rd in g nu tr iti on . E .g ., la nd fo r sc ho ol g ar de ns . M oA , M oE (L ea d) W FP , F AO , W H H , A AH , ZO A an d ot he r re le va nt st ak eh ol de rs 20 .4 0 21 .3 0 0 41 .7 4. E st ab lis h sc ho ol g ar de ns a nd pr ov id e su pp or t f or a gr ic ul tu re in pu ts to in cr ea se n ut ri tio n kn ow le dg e fo r ne w le ar ne rs . M oE (l ea d) , M oA F AO , W FP , an d ot he r re le va nt st ak eh ol de rs 19 4. 2 22 9. 2 26 4. 2 29 9. 2 33 4. 2 1, 32 1. 00 5. M on ito r th e te ac hi ng o f n ut ri tio n ed uc at io n in s ch oo ls (p ri m ar y an d se co nd ar y) M oE M oH , U N IC EF , W FP , a nd ot he r re le va nt st ak eh ol de rs 8. 23 8. 42 8. 62 8. 81 9. 02 43 .1 0 122 7. C on du ct c oo ki ng d em on st ra tio ns to p ro m ot e op tim al n ut ri tio us fo od in cl ud in g ch oi ce a nd c om bi na tio n at sc ho ol s M oE W FP a nd ot he r re le va nt st ak eh ol de rs 1. 90 1. 95 1. 99 2. 04 2. 83 10 .7 0 8. R ev ie w s ch oo l h ea lth s tr at eg y to en su re c oh er en ce w ith L M N CS P. M oE (l ea d) , M oH W FP a nd ot he r re le va nt st ak eh ol de rs 61 .4 0 64 .2 0 67 .2 19 2. 8 9. E ns ur e sc ho ol gi rl s ta ke h om e ra tio n to s af eg ua rd n ut ri tio n. M oE W FP a nd ot he r re le va nt st ak eh ol de rs 15 0 15 0 15 0 15 0 15 0 75 0 10 . S en si tiz e sc ho ol g oi ng c hi ld re n an d ad ol es ce nt s on h ea lth y di et s an d ph ys ic al a ct iv ity u si ng c on te xt – sp ec ifi c co m m un ic at io n ch an ne ls . M oE (l ea d) W FP a nd ot he r re le va nt st ak eh ol de rs 34 4. 2 35 2. 1 36 0. 2 36 8. 5 37 7 1, 80 1. 90 SO , 2 ; S tr at eg y 1: 1 . I nt eg ra te nu tr iti on in to W AS H p ol ic ie s, st ra te gi es , p la ns a nd p ro gr am s (S ch oo l W AS H ) 34 .2 34 .9 35 .7 36 .6 37 .4 17 8. 8 11 . P ro m ot e sc ho ol h ea lth a nd nu tr iti on p ro gr am s fo r he al th y di et s an d go od n ut ri tio n (e g se tt in g up o f ha nd w as hi ng p os ts a nd g ar ba ge co lle ct io n bi ns o n sc ho ol c am pu se s) M oE (l ea d) , M oH , N W AS H C W FP , U N IC EF , an d ot he r re le va nt st ak eh ol de rs 34 .2 34 .9 35 .7 36 .6 37 .4 17 8. 8 SO , 4 ; S tr at eg y 1: 1 . C re at e aw ar en es s on a pp ro pr ia te d ie ta ry pr ac tic es a nd li fe st yl es e ss en tia l f or th e pr ev en tio n of N CD Is p ar tic ul ar ly ta rg et in g gr ou ps m os t a t r is k 33 19 .7 20 .1 20 .6 21 .1 11 4. 5 12 . In co rp or at e N CD r el at ed nu tr iti on g ui de lin es in te ac hi ng cu rr ic ul um M oH , M oE (le ad ) U N IC EF , a nd ot he r re le va nt st ak eh ol de rs 13 .8 0 0 0 0 13 .8 13 . E ns ur e su pp or t t o ho m e gr ow n sc ho ol fe ed in g Pr og ra m M oE , M oA (le ad ) W FP , an d o th er re le va nt st ak eh ol de rs 19 .2 19 .7 20 .1 20 .6 21 .1 10 0. 7 123 In te rv en ti on s: M oG CS P Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 00 0, U SD ) M oG CS P To ta ls 48 2. 10 41 7. 80 42 6. 90 46 8. 00 36 4. 20 2, 15 4. 00 S. O . 2 : S tr at eg y 3: D ev el op a Pa ck ag e of N ut ri tio n an d Ad ol es ce nt Se xu al a nd R ep ro du ct iv e he al th In te rv en tio ns a nd O pe ra tio na l G ui de lin es A pp ro pr ia te fo r Sc ho ol go in g Ch ild re n an d Ad ol es ce nt s 98 3. 07 79 7. 89 99 2. 22 88 7. 36 1, 06 7. 56 4, 72 7. 90 SO , 2 ; S tr at eg y 4. D ev el op a nu tr iti on s en si tiv e pa ck ag e of ca sh tr an sf er in te rv en tio ns a nd ap pr op ri at e op er at io na l g ui de lin es fo r so ci al p ro te ct io n of v ul ne ra bl e ch ild re n an d ad ol es ce nt s to s af e gu id e th ei r nu tr iti on 34 7. 20 33 2. 70 33 6. 10 34 0. 50 24 6. 50 1, 60 3. 00 1. D ev el op g ui de lin es a nd im pl em en t s oc ia l s af et y as si st an ce to p oo r ho us eh ol ds w ith c hi ld re n an d ad ol es ce nt s M oG CS P W or ld B an k, an d ot he r re le va nt st ak eh ol de rs 19 .6 0 0 0 0 19 .6 0 2. C on du ct tr ai ni ng fo r st aff to e na bl e th em id en tif y/ ta rg et vu ln er ab le h ou se ho ld s an d im pl em en t n ut ri tio n se ns iti ve s oc ia l sa fe ty n et s. M oG CS P W or ld B an k, an d ot he r re le va nt st ak eh ol de rs 6 7 6 6 0 25 .0 0 3. S en si tiz e th e po pu la tio n, co m m un ity le ad er s, h us ba nd s/ m al e pa rt ne rs o n th e cr ite ri a of s el ec tio n an d th e pu rp os e of th e so ci al s af et y ne ts to p re ve nt a ny d om es tic o r co m m un ity b ac k cl as h fo r ta rg et ed vu ln er ab le h ou se ho ld s. M oG CS P W or ld B an k, an d ot he r re le va nt st ak eh ol de rs 5 5 5 5 5 25 .0 0 124 4. L ob by w ith s ta ke ho ld er s to pr ov id e su pp or t t ha t a re n ut ri tio n se ns iti ve to in cr ea se th e ca pa ci ty o f vu ln er ab le h ou se ho ld s. M oG CS P W or ld B an k, U N IC EF , U SA ID , a nd ot he r re le va nt st ak eh ol de rs 0 0 0 0 0 0. 00 5. S up po rt p ro vi si on o f s pe ci al iz ed fo od tr an sf er to w om en a nd ch ild re n to s af eg ua rd m at er na l, in fa nt , a nd y ou ng c hi ld n ut ri tio n. M oG CS P W or ld B an k, U N IC EF , U SA ID , a nd ot he r re le va nt st ak eh ol de rs 7. 9 8. 1 8. 3 8. 5 8. 7 41 .5 0 6. E ns ur e ca sh tr an sf er s or o th er fo rm s of s oc ia l t ra ns fe rs to em po w er v ul ne ra bl e co m m un iti es an d ho us eh ol ds ’ a ff or da bi lit y of fo od , p ri or iti zi ng p re gn an t w om en an d ho us eh ol ds p ro vi di ng fo st er ca re fo r or ph an s. M oG CS P W or ld B an k, U N IC EF , U SA ID , a nd ot he r re le va nt st ak eh ol de rs 13 5. 00 13 5. 00 13 5. 00 13 5. 00 13 5. 00 67 5. 00 7. A dv oc at e fo r th e im pl em en ta tio n of m at er ni ty c as h tr an sf er s an d so ci al p ro te ct io n sa fe ty n et pr og ra m s to r ed uc e fin an ci al b ar ri er to g oo d nu tr iti on M oG CS P (le ad ) /M oH W or ld B an k, U N IC EF , U SA ID , a nd ot he r re le va nt st ak eh ol de rs 2. 5 2. 5 2. 6 2. 7 2. 7 13 .0 0 8. S up po rt th e im pl em en ta tio n of ca sh tr an sf er s to h ou se ho ld s w ith po or c hi ld re n an d ad ol es ce nt s. M oG CS P W or ld B an k, U N IC EF , U SA ID , F AO , U N W om en , W FO a nd ot he r re le va nt st ak eh ol de rs 2. 5 2. 5 2. 6 2. 7 2. 7 13 .0 0 9. S up po rt p re gn an t a nd la ct at in g w om en w ith s oc ia l s af et y in te rv en tio ns to e ns ur e m at er ni ty pr ot ec tio ns d ur in g em er ge nc ie s. M oG CS P (le ad )/ M oH U N FP A, U N IC EF , W B, W FP , L M H , an d o th er re le va nt st ak eh ol de rs 16 8. 7 17 2. 6 17 6. 6 18 0. 6 92 .4 79 0. 90 125 SO , 2 ; S tr at eg y 5: I nt eg ra te c as h tr an sf er p ro gr am s to p ro vi de in co m e su pp or t a s so ci al s af et y ne t to v ul ne ra bl e gr ou ps to im pr ov e he al th a nd n ut ri tio n of c hi ld re n in ta rg et ed h ou se ho ld s. 87 .5 47 .5 47 .5 87 .5 80 35 0 10 . E nc ou ra ge n ut ri tio n se ns iti ve vi lla ge s av in g lo an s (s us u) in co m m un iti es a ct iv iti es fo r ec on om ic em po w er m en t o f w om en in vu ln er ab le fa m ili es . M oG CS P W or ld B an k, U N IC EF , U SA ID , U N W om en , W FP , FA O , a nd ot he r re le va nt st ak eh ol de rs 7. 5 7. 5 7. 5 7. 5 0 30 .0 0 11 . P ro vi de u nc on di tio na l c as h tr an sf er s to s af eg ua rd h ea lth y di et s, pa rt ic ul ar ly to v ul ne ra bl e pr eg na nt an d la ct at in g w om en a nd y ou ng ch ild re n. W or ki ng w ith M oA to en co ur ag e m ak in g ga rd en s M oG CS P (le ad )/ M oA W or ld B an k, U N IC EF , U SA ID , a nd ot he r re le va nt st ak eh ol de rs 80 40 40 80 80 32 0. 00 SO , 3 ; S tr at eg y 1: C on du ct c ap ac ity bu ild in g to s tr en gt he n te ch ni ca l ca pa ci ty fo r nu tr iti on p ro gr am im pl em en ta tio n, p ol ic y an al ys is , an d de ve lo pm en t a nd m on ito ri ng o f th ei r im pl em en ta tio n at a ll le ve ls 47 .4 37 .6 43 .3 40 37 .7 20 1 12 . T ra in s ta ke ho ld er s in s oc ia l pr ot ec tio n pr og ra m m es o n go od nu tr iti on p ra ct ic es M oG CS P (le ad )/ M oH U N IC EF , W H O , W FP , a nd ot he r re le va nt st ak eh ol de rs 7. 5 7 7 8 0 29 .5 0 13 . Co nd uc t s ta ke ho ld er m ap pi ng of v ar io us p la ye rs in s oc ia l pr ot ec tio n M oG CS P U N IC EF , W H O , W FP , a nd ot he r re le va nt st ak eh ol de rs 10 0 5 0 5 15 .0 0 126 In te rv en ti on s :N PH IL Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) N PH IL T O TA L 48 2. 3 23 1. 9 39 3. 5 24 2. 8 24 8. 4 1 ,5 99 .1 0 SO , 2 ; S tr at eg y 6: E nh an ce an e ff ec tiv e an d fu nc tio na l in st itu tio na l s ys te m fo r D is as te r Ri sk M an ag em en t, en ha nc e ri sk id en tifi ca tio n m ec ha ni sm s; pr ep ar ed ne ss , e m er ge nc y re sp on se (in cl ud in g nu tr iti on e m er ge nc y re sp on se ) a nd r ec ov er y; im pr ov e in fo rm at io n an d kn ow le dg e m an ag em en t a nd v ul ne ra bi lit y fa ct or s. 33 3. 7 13 3. 3 23 7. 9 13 9. 5 14 2. 7 98 7. 1 1. D ev el op c on tin ge nc y pl an a nd St an da rd O pe ra tin g Pr oc ed ur es (S O P) fo r nu tr iti on e m er ge nc y re sp on se . M oH , N PH IL W H O , U N IC EF , W FP , L as t M ile H ea lth , Co nc er n, AA H , a nd ot he r re le va nt st ak eh ol de rs s 1 0 0 0 0 1 2. T ra in fr on tli ne s ta ff to c on du ct nu tr iti on s ur ve ill an ce a nd r es po ns e in ti m e of e m er ge nc ie s. M oH , N PH IL U N IC EF , W FP , L as t M ile H ea lth , Co nc er n, A AH , an d o th er re le va nt st ak eh ol de rs 54 .8 0 57 .4 0 0 11 2. 2 3. S tr en gt he n th e ca pa ci ty o f fr on tli ne s ta ff to id en tifi ed vu ln er ab le g ro up s in ti m e of d is as te r or e pi de m ic s to r ed uc e ri sk s of m al nu tr iti on . M oH , N PH IL W H O , U N IC EF , an d o th er re le va nt st ak eh ol de rs 54 .8 56 .1 57 .4 58 .7 60 28 7 127 4. F or m ul at e nu tr iti on s tr at eg ie s fo r po st e m er ge nc y co m m un ity re co ve ry . M oH , N PH IL U N IC EF , I ri sh Ai d, W AH O , an d o th er re le va nt st ak eh ol de rs 5. 1 0 0 0 0 5. 1 5. M ap p ar tn er s in d is as te r ri sk m an ag em en t a nd e m er ge nc y re sp on se a nd r ec ov er y M oH , N PH IL U N IC EF , I ri sh Ai d, W AH O , an d o th er re le va nt st ak eh ol de rs 30 .2 0 0 0 0 30 .2 6. E st ab lis h fu nc tio na l d is as te r ri sk m an ag em en t c om m itt ee N PH IL U N IC EF , I ri sh Ai d, W AH O , an d o th er re le va nt st ak eh ol de rs 18 .1 0 0 0 0 18 .1 7. T ra in s ta ke ho ld er s on d is as te r ri sk re du ct io n M oH / N PH IL U N IC EF , I ri sh Ai d, W AH O , an d o th er re le va nt st ak eh ol de rs 33 .1 0 34 .7 0 0 67 .8 8. C on du ct , r ev ie w a nd d is se m in at e ea rl y w ar ni ng s ur ve ys M oH . N PH IL U N IC EF , I ri sh Ai d, W AH O , an d o th er re le va nt st ak eh ol de rs 23 .8 0 0 0 0 23 .8 9. C on du ct a nd d oc um en t o ut co m es of c oo rd in at io n m ee tin g an d jo in t p la nn in g on n ut ri tio n du ri ng em er ge nc ie s N PH IL W H O , U N IC EF , an d ot he r re le va nt IN G O s 9 0 9. 4 0 0 18 .3 10 . B ui ld c ap ac ity o f s ys te m s an d in di vi du al s to u nd er ta ke pr ep ar ed ne ss a nd r es po ns e fu nc tio ns N PH IL U N IC EF , W H O , W FP , Ir is h Ai d an d ot he r re le va nt st ak eh ol de rs 18 .1 0 0 0 0 18 .1 128 11 . T ra in s ta ke ho ld er s on n ee ds as se ss m en t d ur in g em er ge nc ie s an d co nd uc t t he n ee ds a ss es sm en t N PH IL U N IC EF , W H O , W FP , Ir is h Ai d an d ot he r re le va nt st ak eh ol de rs 75 .5 77 .2 79 80 .8 82 .7 39 5. 3 12 . R ev ie w a nd s ha re th e em er ge nc y pr ep ar ed ne ss a nd r es po ns e gu id el in es w ith c ou nt y le ve l d is as te r m an ag em en t t ea m s. M oH , N PH IL (le ad ) U N IC EF , W AS H , L M H , W FP , a nd ot he r re le va nt st ak eh ol de rs 10 .2 0 0 0 0 10 .2 13 . E ns ur e tim el y pr ov is io n of em er ge nc y re sp on se s up pl ie s (fo od an d no n fo od it em s) . M oH , N PH IL (le ad ) W FP , U N IC EF , W H O , a nd ot he r re le va nt st ak eh ol de rs 0 0 0 0 0 0 SO , 2 ; S tr at eg y 7: S ol id ify s ys te m s of r el ev an t g ov er nm en t I ns tit ut io ns to e ns ur e em er ge nc y pr ep ar ed ne ss an d re sp on se . 92 40 .7 96 .3 42 .7 43 .7 31 5. 4 14 . P ro vi de c om m un iti es w ith IP C in fo rm at io n an d m at er ia ls , sp ec ifi ca lly o n Eb ol a, C O VI D 1 9 pr ot oc ol s M oH , N PH IL (le ad ) W H O , U N IC EF , W B an d o th er re le va nt st ak eh ol de rs 10 10 .2 10 .5 10 .7 11 52 .4 15 . C on du ct a w ar en es s an d tr ai n re le va nt n ut ri tio n st ak eh ol de rs to in cr ea se th e kn ow le dg e of co ns um er s on th e da ng er , r is ks an d di se as es d er iv in g fr om th e co ns um pt io n of u ns af e an d su b st an da rd fo od . M oC I ( N SL ), M oH , N PH IL (le ad ) W H O a nd ot he r re le va nt st ak eh ol de rs 82 30 .5 85 .8 32 32 .7 26 3 129 SO 2; S tr at eg y 8: S tr en gt he n co m m un ity p re pa re dn es s, r es po ns e, an d re co ve ry fo r na tu ra l a nd m an m ad e di sa st er s/ ou tb re ak s th ro ug h na tio na l e m er ge nc y re sp on se a nd re co ve ry s tr at eg y. 56 .6 57 .9 59 .3 60 .6 62 29 6. 6 16 . P ro cu re a nd p re p os iti on nu tr iti on e m er ge nc y su pp lie s in a ll co un tie s an d di st ri ct s. M oH , N PH IL U N IC EF , W H O , an d o th er re le va nt st ak eh ol de rs 0 0 0 0 0 0 17 . S up po rt r es ili en ce b ui ld in g in th e co m m un iti es ’ e m er ge nc y re sp on se an d re co ve ry p la ns to e nh an ce e ar ly re co ve ry M oH , N PH IL (le ad ) U N D P, W H O , U N IC EF , a nd ot he r re le va nt st ak eh ol de rs 56 .6 57 .9 59 .3 60 .6 62 29 6. 6 To ta l 1, 63 8. 70 M in is tr y of P ub lic W or ks In te rv en ti on s, M PW Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (i n 00 0, U SD ) M PW T O TA L 63 .7 13 .9 14 .1 39 .4 14 .6 SO , 2 ; S tr at eg y 2: A do pt a pp ro pr ia te te ch no lo gi es fo r th e pr od uc tio n, pr oc es si ng a nd h an dl in g of ag ri cu ltu ra l p ro du ct s to im pr ov e ho us eh ol d fo od s ec ur ity 63 .7 13 .9 14 .1 39 .4 14 .6 14 . N eg ot ia te fo r co ns tr uc tio n an d re ha bi lit at io n of fa rm to m ar ke t ro ad s an d pr io ri tiz e pr od uc tiv e co m m un iti es to im pr ov e ac ce ss to lo ca l m ar ke t M PW (L ea d) , M oA F AO , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 10 .2 10 .4 10 .6 10 .9 11 .1 15 . T ra in C BO s fo r fe ed er r oa ds m ai nt en an ce M PW FA O , W FP , AA H , Z O A an d ot he r re le va nt st ak eh ol de rs 3. 5 3. 5 3. 5 3. 5 3. 5 130 16 . R oa d co ns tr uc tio n eq ui pm en ts to b e av ai la bl e in e ac h co un ty to en ab le r oa d m ai nt en an ce a nd co ns tr uc tio n fo r fa rm to m ar ke ts . M PW U N D P, F AO , W FP , A AH , ZO A an d ot he r re le va nt st ak eh ol de rs 50 0 0 25 0 $7 5. 00 In te rv en ti on s: N aF A A Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 20 27 (in 00 0, U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (i n 00 0, U SD ) N aF AA T ot al 75 72 .3 72 .3 72 .3 72 .3 O 2, S tr at eg y 2: A do pt a pp ro pr ia te te ch no lo gi es fo r th e pr od uc tio n, pr oc es si ng , a nd h an dl in g of ag ri cu ltu ra l p ro du ct s to im pr ov e ho us eh ol d fo od s ec ur ity 75 72 .3 72 .3 72 .3 72 .3 36 4. 3 8. C ap ac ita te fa rm er s to im pl em en t Fi sh a nd In se ct fa rm in g fo r th e pr od uc tio n of a ni m al s ou rc e fo od in su pp or t o f h ea lth y di et s (e .g ., Fi sh fa rm in g, B ee ke ep in g an d H on ey pr od uc tio n an d va lu e ch ai n, s na il ra is in g, e tc .). N aF AA (l ea d) F AO , W H H , Co nc er n, Z O A an d ot he r re le va nt st ak eh ol de rs 75 72 .3 72 .3 72 .3 72 .3 36 4. 3 In te rv en ti on s: N aF A A Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 20 27 (in 00 0, U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (i n 00 0, U SD ) N W AS H C TO TA LS 2, 54 0. 00 2, 50 7. 80 2, 52 4. 60 2, 75 7. 60 2, 28 8. 40 9, 67 7. 20 SO , 2 ; S tr at eg y 1: In te gr at e N ut ri tio n in to W AS H p ol ic ie s, s tr at eg ie s, p la ns an d pr og ra m s 25 40 25 07 .8 25 24 .6 27 57 .6 22 88 .4 9, 67 7. 20 1. E du ca te , s en si tiz e, a nd in flu en ce so ci al m ar ke tin g em ph as iz in g lin ks be tw ee n po or W AS H a nd u nd er nu tr iti on . N W AS H C (L ea d) , M oH U N IC EF , W H O , N PH IL , W at er Ai d, Co nc er n, a nd ot he r re le va nt st ak eh ol de rs 10 0 10 0 10 0 11 5 12 0 53 5. 00 131 2 Su pp or t B ab y W AS H in te rv en tio ns to im pr ov e M at er na l, N ew bo rn an d Ch ild h ea lth , E ar ly c hi ld ho od de ve lo pm en t, an d nu tr iti on . N W AS H C (le ad ), M oH U N IC EF , W H O , N PH IL , W at er Ai d, Co nc er n, a nd ot he r re le va nt st ak eh ol de rs 93 10 0 80 10 0 10 0 47 3. 00 3. E m ba rk o n ha nd w as hi ng ed uc at io n an d pr om ot io n at a ll tim es . N W AS H C (le ad ) U N IC EF , W H O , N PH IL , W at er Ai d, Co nc er n an d ot he r re le va nt st ak eh ol de rs 82 .7 84 .6 86 .6 88 .6 90 .6 43 3. 10 4. P ro vi si on o f h an dw as hi ng su pp lie s an d st at io ns /t ip py ta ps a t al l l ev el s. N W AS H C W H O , U N IC EF , N PH IL , W at er Ai d, Co nc er n an d ot he r re le va nt IN G O s 60 0 61 3. 8 62 7. 9 64 2. 4 65 7. 1 20 0. 00 5. T ra in C BO s to b e em po w er ed to su pe rv is e th e us e an d m ai nt en an ce of c om m un ity W AS H fa ci lit ie s. N W AS H C W H O , U N IC EF , N PH IL , W at er Ai d, Co nc er n an d ot he r re le va nt IN G O s 39 39 .9 40 .8 41 .7 0 16 1. 40 6. P ro m ot e en vi ro nm en ta l h yg ie ne in p ub lic a re as a nd d om es tic fa ci lit ie s. N W AS H C (le ad ), EP A W H O , U N EP , N PH IL a nd ot he r re le va nt st ak eh ol de rs . 20 0 25 0 20 0 26 0 16 8. 7 1, 07 8. 70 7. P ro m ot e O pe n D ef ec at io n Fr ee (O D F) v ill ag es N W AS H C W H O , U N IC EF , W at er Ai d, Co nc er n an d ot he r re le va nt st ak eh ol de rs 52 2. 8 53 4. 8 54 7. 1 55 9. 7 57 2. 5 2, 73 6. 90 132 8. S up po rt s an ita tio n fa ci lit ie s de si gn s se ns iti ve to v ul ne ra bl e gr ou ps N W AS H C (le ad ), M oG CS P U N IC EF , W at er Ai d, a nd ot he r re le va nt st ak eh ol de rs 52 .4 53 .6 54 .8 56 .1 28 .7 24 5. 60 9. Im pr ov em en t o f w at er s up pl y sy st em s an d se rv ic es fo r ac ce ss to sa fe d ri nk in g w at er . N W AS H C U N IC EF , PW , W at er an d Se w ar d, N PH IL , W at er Ai d, Co nc er n, N SL an d ot he r re le va nt St ak eh ol de rs . 0 0 0 0 0 0. 00 10 . E ns ur e co ns tr uc tio n an d re ha bi lit at io n of b or eh ol es a nd ha nd d ug w el ls fi tt ed w ith h an d pu m ps to g et c le an w at er a t co m m un ity le ve ls . N W AS H C (le ad ), N PH IL U N IC EF , W at er A ID , an d ot he r re le va nt st ak eh ol de rs 0 0 0 0 0 0. 00 11 . P ro m ot e ho us eh ol d w at er tr ea tm en t t ec hn ol og ie s an d sa fe st or ag e w ith in h ou se ho ld s, h ea lth fa ci lit ie s an d sc ho ol s. N W AS H C (le ad ) N PH IL U N IC EF , W H O , a nd ot he r re le va nt st ak eh ol de rs 50 0 45 0 50 0 60 0 25 0 2, 30 0. 00 12 . A do pt a nd r ev ie w a va ila bl e re gi on al a nd in te rn at io na l W AS H st an da rd s S U N , N W AS H C, (le ad ) N PH IL R EA CH , U N IC EF , W H O , N SL /M oC I a nd ot he r re le va nt st ak eh ol de rs 75 .3 0 0 0 0 75 .3 0 13 . C on du ct s en si tiz at io n on s af e an d hy gi en ic p ra ct ic es d ur in g fo od pr ep ar at io n an d st or ag es N W AS H C (le ad ) N PH IL M oH , R EA CH , U N IC EF , W H O , N SL /M oC I a nd ot he r re le va nt st ak eh ol de rs 12 6. 6 12 9. 5 13 2. 4 13 5. 5 13 8. 6 66 2. 60 133 14 . A dv oc at e fo r pr ot ec tio n of w at er so ur ce s an d re gu la r w at er tr ea tm en t qu al ity c he ck s. N W AS H C (le ad ) N PH IL M oH , R EA CH , U N IC EF , W H O , N SL /M oC I a nd ot he r re le va nt st ak eh ol de rs 86 .5 88 .5 90 .5 92 .6 94 .7 45 2. 80 15 . S tr en gt he n m ec ha ni sm s fo r co lla bo ra tio n an d pr om ot e pa rt ic ip at io n of s ta ke ho ld er s in W AS H fo ru m s. N W AS H C (le ad ) N PH IL M oH , R EA CH , U N IC EF , W H O , N SL /M oC I a nd ot he r re le va nt st ak eh ol de rs 61 .7 63 .1 64 .5 66 67 .5 32 2. 80 In te rv en ti on s S U N Se cr et ar ia t Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 20 28 (in 00 0, U SD ) T O TA L (i n 00 0, U SD ) SU N S EC T O TA LS 4, 12 5. 70 3, 39 3. 00 3 ,5 95 .2 0 3, 51 6. 00 3 ,6 40 .2 0 18 ,2 70 .3 0 SO , 3 ; S tr at eg y 1: R ev ie w , u pd at e an d /o r fo rm ul at e le gi sl at io n, gu id el in es , s ta nd ar ds a nd c od e of pr ac tic e on fo od q ua lit y an d sa fe ty 19 .5 0 0 0 0 19 .5 1. A dv oc at e fo r le gi sl at io ns in th e co nt ro l o f m ar ke tin g of u nh ea lth y fo od M oC I, M oH , SU N (l ea d) U N IC EF , W FP , F AO a nd ot he r re le va nt st ak eh ol de rs 19 .5 0 0 0 0 19 .5 SO 3; S tr at eg y 4: In te gr at e N ut ri tio n G oa ls in to N at io na l D ev el op m en t Pl an s, S ec to ra l P ol ic ie s/ Pl an s, Pr og ra m s an d Pr oj ec ts 53 5. 40 49 8. 00 5 60 .2 0 5 21 .1 0 5 33 .1 0 2, 64 7. 90 1. R ev ie w a ll nu tr iti on s en si tiv e ke y se ct or s an nu al p ro gr am s (A gr ic ul tu re , E du ca tio n, N W AS H C, So ci al W el fa re , e tc . t o en su re th ey re fle ct s ou nd n ut ri tio n se ns iti ve le ns . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 48 .6 0 50 .8 0 0 99 .4 2. O ri en ta te a nd tr ai n al l r el ev an t se ct or s st ak eh ol de rs a t a ll le ve ls to en fo rc e th e Fo od a nd N ut ri tio n le ga l in st ru m en ts /S ta nd ar ds . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 48 6. 8 49 8 50 9. 4 52 1. 1 53 3. 1 2, 54 8. 50 134 SO 3 ; S tr at eg y 5: A dv oc at e to Im pr ov e Aw ar en es s Am on g D ec is io n M ak er s on th e Ro le o f N ut ri tio n in N at io na l D ev el op m en t a nd h ow Se ct or s ca n W or k To ge th er to Ac hi ev e D es ir ab le C ha ng e. 14 3. 2 85 .6 87 .7 89 .5 91 .6 49 7. 6 3. E ng ag in g th e O ffi ce o f t he Pr es id en t f or th e id en tifi ca tio n of N ut ri tio n Ch am pi on S U N S ec . R EA CH , a nd ot he r re le va nt st ak eh ol de rs 32 .5 0 0 0 0 32 .5 4. E ns ur e th at r el ev an t s ec to rs fo rm ul at e an d de si gn p ro gr am s w ith nu tr iti on le ns . S U N (l ea d) , N W AS H C U N IC EF , RE AC H , N PH IL , Co nc er n, W at er Ai d an d ot he r re le va nt St ak eh ol de rs 26 .9 0 0 0 0 26 .9 5. S ca le u p aw ar en es s on th e im po rt an ce o f n ut ri tio n to n at io na l de ve lo pm en t a m on g ke y po lit ic al an d ec on om ic d ec is io n m ak er s th ro ug h fo ru m s an d pr es en ta tio ns at S ec tio ns o f t he H ou se o f Re pr es en ta tiv es a nd S en at e an d al l re le va nt s ec to rs a t a ll le ve ls . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 6. S up po rt a nn ua l n ut ri tio n le ar ni ng fo ru m s S U N , M SP R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 7. P ar tic ip at e in r eg io na l a nd g lo ba l in te rn at io na l m ee tin gs o n nu tr iti on S U N , M SP R EA CH a nd ot he r re le va nt st ak eh ol de rs 18 .8 19 .2 19 .7 20 .1 20 .6 98 .4 135 SO 3 ; S tr at eg ic 6 : A dv oc at e fo r G ra du al In cr ea se o f F in an ci al Al lo ca tio ns fo r N ut ri tio n by th e G ov er nm en t. 24 8. 3 23 3. 7 25 9. 8 24 4. 4 25 0 12 36 .2 8. A dv oc at e fo r th e cr ea tio n of a bu dg et li ne fo r SU N S ec re ta ri at a nd re le va nt p ar tn er s. S U N , M SP R EA CH a nd ot he r re le va nt st ak eh ol de rs 19 .5 0 20 .4 0 0 39 .9 9. A dv oc at e fo r ad eq ua te fi na nc ia l re so ur ce s fo r su st ai ne d an d qu al ity nu tr iti on s er vi ce s in cl ud in g do m es tic re so ur ce m ob ili za tio n S U N , M SP U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 10 . E ng ag e he ad s of r el ev an t m in is tr ie s an d ag en ci es fo r th e de ve lo pm en t o f b ud ge t l in es fo r nu tr iti on . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 19 .5 19 .9 20 .4 20 .9 21 .3 10 2 11 . S up po rt to in cr ea se m ul ti se ct or al fi na nc ia l i nv es tm en t fo r nu tr iti on b y al l s ta ke ho ld er s (th ro ug h ro un dt ab le s, fu nd in g st ra te gi es ). S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 12 . R eg ul ar ly a dv oc at e fo r th e tim el y di sb ur se m en t o f f un ds fo r nu tr iti on re la te d ac tiv iti es S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 13 . C on du ct h ig h le ve l f un d ra is in g fo r th e N M N CS P im pl em en ta tio n. S U N , M SP U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 136 14 . C on du ct a nn ua l d on or g ro up fo ru m s on n ut ri tio n S U N , M SP U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 15 . D ev el op a nn ua l r es ou rc e m ob ili za tio n st ra te gy S U N , M SP U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 16 . C on du ct n ut ri tio n re so ur ce tr ac ki ng a t n at io na l a nd c ou nt y le ve l S U N , M SP U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 14 .3 14 .6 15 15 .3 15 .7 74 .9 SO , 3 ; S tr at eg y 7: C on du ct C ap ac ity Bu ild in g to S tr en gt he n Te ch ni ca l Ca pa ci ty fo r N ut ri tio n Pr og ra m Im pl em en ta tio n, P ol ic y An al ys is , D ev el op m en t a nd M on ito ri ng o f th ei r Im pl em en ta tio n at a ll Le ve ls 75 6. 8 42 0. 2 43 0 40 5 41 4. 3 24 26 .1 1. C on du ct c ap ac ity s tr en gt he ni ng an d tr ai ni ng s of r el ev an t n ut ri tio n st ak eh ol de rs o n pl an ni ng , im pl em en ta tio n, a nd m an ag em en t of n ut ri tio n pr og ra m s S U N , M oH R EA CH , M oC I an d ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 2. A dv oc at e fo r H um an R es ou rc e de ve lo pm en t s pe ci al ty in N ut ri tio n at P ri m ar y, S ec on da ry a nd T er tia ry le ve ls . S U N , M SP R EA CH , a nd ot he r re le va nt st ak eh ol de rs 0 33 .2 0 0 0 33 .2 137 3. Id en tif y kn ow le dg e ga ps a nd st re ng th en h um an c ap ac ity an d un de rs ta nd in g of n ut ri tio n in te rv en tio ns in li ne w ith th e de fin ed m ul ti se ct or in st itu tio na l ar ra ng em en t. S U N , M SP R EA CH , a nd ot he r re le va nt st ak eh ol de rs 32 .5 0 34 0 0 66 .4 4. C on du ct p re s er vi ce a nd in se rv ic e tr ai ni ng fo r nu tr iti on o ffi ce rs , fr on tli ne w or ke rs a nd o th er c ad re s of s er vi ce p ro vi de rs in vo lv ed in nu tr iti on p ro gr am m in g. S U N M SP M FD P, M oH , U N IC EF , a nd ot he r re le va nt st ak eh ol de rs 34 5. 9 35 3. 8 36 2 37 0. 3 37 8. 8 1, 81 0. 70 5. A dv oc at e fo r es ta bl is hm en t of a n at io na l n ut ri tio n Ce nt er o f Ex ce lle nc e S U N M SP M FD P, M oH , U N IC EF , a nd ot he r re le va nt st ak eh ol de rs 34 5. 9 0 0 0 0 34 5. 9 SO 5 ; S tr at eg y 3: S tr en gt he n In fo rm at io n Sy st em s to E ns ur e th e In te gr at io n, T ra ck in g of P ro gr es s, An al ys is , a nd th e U se o f t he In fo rm at io n fo r D ec is io n M ak in g 68 .9 49 .5 61 .1 51 .9 52 .9 28 4. 7 8. H ol d fo ru m s fo r di ss em in at io n of o pe ra tio na l r es ea rc h an d in fo rm at io n sh ar in g M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 0 0 0 0 10 .2 9. S tr en gt he n sy st em at ic r ev ie w o f nu tr iti on s en si tiv e an d nu tr iti on sp ec ifi c re se ar ch M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 0 10 .6 0 0 20 .8 10 . P ro m ot e kn ow le dg e sh ar in g fo ru m s su ch a s sy m po si um s an d co nf er en ce s, w or ks ho ps , a nd m ee tin gs M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 10 .4 10 .6 10 .9 11 .1 53 .3 138 11 . E st ab lis h an e ff ec tiv e m ec ha ni sm fo r kn ow le dg e m an ag em en t a nd le ar ni ng M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 10 .4 10 .6 10 .9 11 .1 53 .3 12 . P ro m ot e kn ow le dg e sh ar in g th ro ug h pu bl ic at io n M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 10 .4 10 .6 10 .9 11 .1 53 .3 13 . S ca le u p aw ar en es s on th e im po rt an ce o f n ut ri tio n to n at io na l de ve lo pm en t a m on g ke y po lit ic al an d ec on om ic d ec is io n m ak er s th ro ug h fo ru m s an d pr es en ta tio ns at n at io na l a ss em bl ie s an d al l re le va nt s ec to rs a t a ll le ve ls . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .9 18 .3 18 .7 19 .2 19 .6 93 .8 S O , 4 ; S tr at eg y 6: E ar m ar k Re gu la r an d Fi xe d M ee tin g D at es in A dv an ce . 77 5. 2 79 2. 9 81 1. 1 82 9. 9 84 8. 9 40 58 .2 14 . S up po rt th e es ta bl is hm en t of c ou nt y an d di st ri ct le ve l co or di na tio n m ec ha ni sm fo r nu tr iti on s pe ci fic a nd n ut ri tio n se ns iti ve in te rv en tio n. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .5 17 .9 18 .3 18 .8 19 .2 91 .8 15 . H ol d hi gh le ve l s en si tiz at io n fo ra ta rg et in g po lic y m ak er o n th e va lu e an d im pa ct o f p ri or iti zi ng n ut ri tio n S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 9 9. 2 9. 4 9. 6 9. 8 46 .9 16 . S up po rt d is tr ic ts to d ev el op co un ty a dv oc ac y, c om m un ic at io n an d so ci al m ob ili za tio n pl an s. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 26 .2 26 .8 27 .4 28 .1 28 .7 13 7. 3 17 . E ng ag e nu tr iti on c ha m pi on s to a dv oc at e fo r pr io ri tiz at io n of nu tr iti on a t a ll le ve ls S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 24 .8 25 .4 26 26 .6 27 .2 13 0. 1 18 . C on du ct a nn ua l H ig h le ve l m in is te ri al n ut ri tio n m ee tin g to sh ar e na tio na l p ro gr es s up da te s in cr ea se a w ar en es s. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 139 19 . D ev el op a nd d is se m in at e qu ar te rl y nu tr iti on b ul le tin s S U N S ec . R EA CH , a nd ot he r re le va nt IN G O s ot he r re le va nt st ak eh ol de rs 11 8. 7 12 1. 4 12 4. 2 12 7. 1 13 0 62 1. 5 20 . C on du ct b i-m on th ly T ec hn ic al W or ki ng G ro up m ee tin gs (M IY CN , N ut ri tio n in fo rm at io n, E m er ge nc y nu tr iti on , A dv oc ac y m ee tin g) S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 34 4. 7 35 2. 6 36 0. 7 36 9 37 7. 5 1, 80 4. 40 21 . C on du ct C ou nt y an d di st ri ct le ve l nu tr iti on c oo rd in at io n m ee tin g S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 20 1. 8 20 6. 4 21 1. 1 21 6 22 1 1, 05 6. 30 S O 5; S tr at eg y 2: In te gr at e an d As si m ila te S ta nd ar d N ut ri tio n In di ca to rs in to S ec to ra l I nf or m at io n Sy st em s w ith a P ri or ity fo r H M IS . 80 2. 4 63 5. 7 65 0. 4 66 5. 3 68 0. 6 34 34 .3 21 . I nt eg ra te n ut ri tio n se ns iti ve in di ca to rs in cl ud in g Ag ri cu ltu re , Ed uc at io n, W AS H a nd S oc ia l Pr ot ec tio n pe rf or m an ce a nd im pa ct in di ca to rs . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 29 .7 30 .4 31 .1 31 .8 32 .5 15 5. 4 22 . D efi ne a nd In te gr at e co re N ut ri tio n In di ca to rs in N ut ri tio n H ea lth M an ag em en t I nf or m at io n Sy st em (H M IS ) a nd r el ev an t e xi st in g pl at fo rm s. S U N S ec . R EA CH , a nd ot he r re le va nt IN G O s ot he r re le va nt st ak eh ol de rs 29 .7 0 0 0 0 29 .7 23 . H ol d fe ed ba ck m ee tin gs a m on g nu tr iti on s ta ke ho ld er s at a ll le ve ls ; U pd at e an d m ai nt ai n na tio na l nu tr iti on w eb si te S U N S ec . R EA CH , a nd ot he r re le va nt IN G O s ot he r re le va nt st ak eh ol de rs 10 1. 5 0 0 0 0 10 1. 5 24 . T ra ck p ro gr es s an d ch al le ng es of a ll re le va nt n ut ri tio n sp ec ifi c an d N ut ri tio n Se ns iti ve a nd s ha re o n a co m m on p la tf or m . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 18 5. 3 18 9. 6 19 4 19 8. 4 20 3 97 0. 3 11 . E st ab lis h an e ff ec tiv e m ec ha ni sm fo r kn ow le dg e m an ag em en t a nd le ar ni ng M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 10 .4 10 .6 10 .9 11 .1 53 .3 12 . P ro m ot e kn ow le dg e sh ar in g th ro ug h pu bl ic at io n M oH , S U N M SP (l ea d) U N IC EF , W FP , an d ot he r re le va nt st ak eh ol de rs 10 .2 10 .4 10 .6 10 .9 11 .1 53 .3 13 . S ca le u p aw ar en es s on th e im po rt an ce o f n ut ri tio n to n at io na l de ve lo pm en t a m on g ke y po lit ic al an d ec on om ic d ec is io n m ak er s th ro ug h fo ru m s an d pr es en ta tio ns at n at io na l a ss em bl ie s an d al l re le va nt s ec to rs a t a ll le ve ls . S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .9 18 .3 18 .7 19 .2 19 .6 93 .8 S O , 4 ; S tr at eg y 6: E ar m ar k Re gu la r an d Fi xe d M ee tin g D at es in A dv an ce . 77 5. 2 79 2. 9 81 1. 1 82 9. 9 84 8. 9 40 58 .2 14 . S up po rt th e es ta bl is hm en t of c ou nt y an d di st ri ct le ve l co or di na tio n m ec ha ni sm fo r nu tr iti on s pe ci fic a nd n ut ri tio n se ns iti ve in te rv en tio n. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .5 17 .9 18 .3 18 .8 19 .2 91 .8 15 . H ol d hi gh le ve l s en si tiz at io n fo ra ta rg et in g po lic y m ak er o n th e va lu e an d im pa ct o f p ri or iti zi ng n ut ri tio n S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 9 9. 2 9. 4 9. 6 9. 8 46 .9 16 . S up po rt d is tr ic ts to d ev el op co un ty a dv oc ac y, c om m un ic at io n an d so ci al m ob ili za tio n pl an s. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 26 .2 26 .8 27 .4 28 .1 28 .7 13 7. 3 17 . E ng ag e nu tr iti on c ha m pi on s to a dv oc at e fo r pr io ri tiz at io n of nu tr iti on a t a ll le ve ls S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 24 .8 25 .4 26 26 .6 27 .2 13 0. 1 18 . C on du ct a nn ua l H ig h le ve l m in is te ri al n ut ri tio n m ee tin g to sh ar e na tio na l p ro gr es s up da te s in cr ea se a w ar en es s. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 140 25 . C on du ct r ou tin e nu tr iti on d at a qu al ity a ss es sm en ts a nd a ud its w ith ke y se ct or s S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 40 6. 4 41 5. 7 42 5. 3 43 5. 1 44 5. 1 2, 12 7. 60 26 . C on du ct n ut ri tio n da ta c lin ic to r efl ec t o n N IS p ro ce ss es , k ey em er gi ng is su es , l es so ns le ar nt fr om fie ld im pl em en ta tio n an d ta p in to na tio na l, re gi on al , a nd g lo ba l S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 16 .1 0 0 0 0 16 .1 27 . R ev ie w a nd v al id at e m et ho do lo gi es a nd r es ul ts a nd qu al ity m on ito ri ng d ur in g nu tr iti on su rv ey s – SM AR T, M IY CN K AP , K PC an d co ve ra ge s ur ve ys S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .6 0 0 0 0 17 .6 28 . C on du ct In te gr at ed N ut ri tio n SM AR T Su rv ey s M IY CN , K AP , K PC an d co ve ra ge a ss es sm en t. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 16 .1 0 0 0 0 16 .1 SO , 4 ; S tr at eg y 4: D ev el op th e Ca pa ci ty o f C om m un ity a nd F ac ili ty ba se d Se rv ic e Pr ov id er s on E ss en tia l Sk ill s an d Co m pe te nc ie s in N ut ri tio n 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 29 . C on du ct a nn ua l, m id te rm a nd en d te rm r ev ie w s / e va lu at io ns S U N S ec . W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 SO 5; S tr at eg y 1: S tr en gt he n Ex is tin g Sy st em s an d Ca pa ci ty to C ol le ct , An al yz e, R ep or t a nd M on ito r N ut ri tio n Si tu at io ns to E ns ur e th e U til iz at io n of D at a fo r D ec is io n M ak in g. 74 3. 5 64 4. 2 70 0. 9 67 4. 2 73 3. 3 34 95 .9 30 . M ap o ng oi ng n ut ri tio n re se ar ch an d re se ar ch er s in L ib er ia S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 6. 9 7 7. 2 7. 3 7. 5 35 .9 31 . I nt eg ra te n ut ri tio n re se ar ch in to th e na tio na l r es ea rc h st ra te gy S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 29 .7 0 0 0 0 29 .7 141 33 . C on du ct n ut ri tio n da ta di ss em in at io n on a q ua rt er ly b as is S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 87 .6 89 .6 91 .7 93 .8 95 .9 45 8. 5 34 . C on du ct a n an nu al N at io na l M ul ti Se ct or al N ut ri tio n co nf er en ce ev er y tw o ye ar s S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 10 .2 0 10 .6 0 11 .1 32 35 . E st ab lis h an d sc al e up a n in te gr at ed fo od a nd N ut ri tio n su rv ei lla nc e sy st em fo r re al ti m e m on ito ri ng a t a ll le ve ls S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 6. 9 7 7. 2 7. 3 7. 5 35 .9 36 . E st ab lis he d a co un tr y, c ou nt y, an d di st ri ct le ve ls w eb si te to m an ag e an d sh ar e nu tr iti on in fo rm at io n in th e fo rm o f a d as hb oa rd w ith k ey st ak eh ol de rs S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 7. 2 0 0 0 0 7. 2 37 . C on du ct m on th ly m ul ti se ct or al nu tr iti on c oo rd in at io n m ee tin g S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 12 2. 1 12 4. 9 12 7. 8 13 0. 7 13 3. 7 63 9. 1 38 . C on du ct r ou tin e nu tr iti on d at a qu al ity a ss es sm en ts a nd a ud its w ith ke y se ct or S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 40 6. 4 41 5. 7 42 5. 3 43 5. 1 44 5. 1 2, 12 7. 60 39 . D ev el op a n at io na l n ut ri tio n re so ur ce tr ac ki ng to ol S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 36 .8 0 0 0 0 36 .8 25 . C on du ct r ou tin e nu tr iti on d at a qu al ity a ss es sm en ts a nd a ud its w ith ke y se ct or s S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 40 6. 4 41 5. 7 42 5. 3 43 5. 1 44 5. 1 2, 12 7. 60 26 . C on du ct n ut ri tio n da ta c lin ic to r efl ec t o n N IS p ro ce ss es , k ey em er gi ng is su es , l es so ns le ar nt fr om fie ld im pl em en ta tio n an d ta p in to na tio na l, re gi on al , a nd g lo ba l S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 16 .1 0 0 0 0 16 .1 27 . R ev ie w a nd v al id at e m et ho do lo gi es a nd r es ul ts a nd qu al ity m on ito ri ng d ur in g nu tr iti on su rv ey s – SM AR T, M IY CN K AP , K PC an d co ve ra ge s ur ve ys S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .6 0 0 0 0 17 .6 28 . C on du ct In te gr at ed N ut ri tio n SM AR T Su rv ey s M IY CN , K AP , K PC an d co ve ra ge a ss es sm en t. S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 16 .1 0 0 0 0 16 .1 SO , 4 ; S tr at eg y 4: D ev el op th e Ca pa ci ty o f C om m un ity a nd F ac ili ty ba se d Se rv ic e Pr ov id er s on E ss en tia l Sk ill s an d Co m pe te nc ie s in N ut ri tio n 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 29 . C on du ct a nn ua l, m id te rm a nd en d te rm r ev ie w s / e va lu at io ns S U N S ec . W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 SO 5; S tr at eg y 1: S tr en gt he n Ex is tin g Sy st em s an d Ca pa ci ty to C ol le ct , An al yz e, R ep or t a nd M on ito r N ut ri tio n Si tu at io ns to E ns ur e th e U til iz at io n of D at a fo r D ec is io n M ak in g. 74 3. 5 64 4. 2 70 0. 9 67 4. 2 73 3. 3 34 95 .9 30 . M ap o ng oi ng n ut ri tio n re se ar ch an d re se ar ch er s in L ib er ia S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 6. 9 7 7. 2 7. 3 7. 5 35 .9 31 . I nt eg ra te n ut ri tio n re se ar ch in to th e na tio na l r es ea rc h st ra te gy S U N S ec . R EA CH a nd ot he r re le va nt st ak eh ol de rs 29 .7 0 0 0 0 29 .7 142 In te rv en ti on s M IC A T Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) M IC AT T O TA L 66 .2 22 22 .5 23 23 .5 15 7. 2 SO , 4 ; S tr at eg y 3: D ev el op a S oc ia l Be ha vi ou r Ch an ge C om m un ic at io n St ra te gy to In cr ea se K no w le dg e an d Pr om ot e Po si tiv e N ut ri tio n Be ha vi or 66 .2 22 22 .5 23 23 .5 15 7. 2 1. T ra ns la te S BC C in to v ar io us lo ca l l an gu ag es a nd a ir v ia r ad io to in cr ea se k no w le dg e an d pr om ot e po si tiv e nu tr iti on b eh av io ur a t a ll le ve ls M IC AT (l ea d) M oH , U N IC EF , an d ot he r re le va nt st ak eh ol de rs 66 .2 22 22 .5 23 23 .5 15 7. 2 2 . S up po rt d et er m in at io n of th e ne ga tiv e eff ec ts o f s m ok in g, su bs ta nc e ab us e, a lc oh ol a nd T hi er s se qu en t N CD s vi a so ci al m ed ia , ra di os a nd T V pr og ra m s to th e pu bl ic . M IC AT (l ea d) M oH , M oE , PI H a nd o th er re le va nt st ak eh ol de rs In te rv en ti on s M oF D P Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) M IC AT T O TA L 66 .2 22 22 .5 23 23 .5 15 7. 2 M FD P TO TA L 20 0. 6 16 7. 3 17 1. 4 17 5 17 9 89 3. 3 SO 3; S tr at eg ic 6 : A dv oc at e fo r G ra du al In cr ea se o f F in an ci al Al lo ca tio ns fo r N ut ri tio n by th e G ov er nm en t. 20 0. 6 16 7. 3 17 1. 4 17 5 17 9 89 3. 3 1. E ns ur e th at r el ev an t m in is tr ie s an d ag en ci es fo r th e de ve lo pm en t o f bu dg et li ne s fo r nu tr iti on . M FD P R EA CH a nd ot he r re le va nt st ak eh ol de rs 19 .5 19 .9 20 .4 20 .9 21 .3 10 2 2. S up po rt to in cr ea se m ul ti se ct or al fin an ci al in ve st m en t f or n ut ri tio n by a ll st ak eh ol de rs (t hr ou gh ro un dt ab le s, fu nd in g st ra te gi es ). M FD P R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 143 3. R eg ul ar ly m on ito r th e tim el y di sb ur se m en t o f f un ds fo r nu tr iti on re la te d ac tiv iti es M FD P R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 15 7. 2 4. C on du ct h ig h le ve l f un d ra is in g fo r th e LM N CS P im pl em en ta tio n. M FD P U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 5. C on du ct n ut ri tio n re so ur ce tr ac ki ng a t n at io na l a nd c ou nt y le ve l M FD P U N IC EF , W AH O , U N D P, Ir is h Ai d, W B, an d ot he r re le va nt st ak eh ol de rs 14 .3 14 .6 15 15 .3 15 .7 10 2 6. C on du ct c ap ac ity s tr en gt he ni ng an d tr ai ni ng s of r el ev an t n ut ri tio n st ak eh ol de rs o n pl an ni ng , im pl em en ta tio n an d m an ag em en t of n ut ri tio n pr og ra m s M FD P RE AC H a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 7 . D ev el op a n at io na l n ut ri tio n re so ur ce tr ac ki ng to ol M FD P R EA CH a nd ot he r re le va nt st ak eh ol de rs 36 .8 0 0 0 0 36 .8 In te rv en ti on s M IC A T Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) M IC AT T O TA L 66 .2 22 22 .5 23 23 .5 15 7. 2 SO , 4 ; S tr at eg y 3: D ev el op a S oc ia l Be ha vi ou r Ch an ge C om m un ic at io n St ra te gy to In cr ea se K no w le dg e an d Pr om ot e Po si tiv e N ut ri tio n Be ha vi or 66 .2 22 22 .5 23 23 .5 15 7. 2 1. T ra ns la te S BC C in to v ar io us lo ca l l an gu ag es a nd a ir v ia r ad io to in cr ea se k no w le dg e an d pr om ot e po si tiv e nu tr iti on b eh av io ur a t a ll le ve ls M IC AT (l ea d) M oH , U N IC EF , an d ot he r re le va nt st ak eh ol de rs 66 .2 22 22 .5 23 23 .5 15 7. 2 2 . S up po rt d et er m in at io n of th e ne ga tiv e eff ec ts o f s m ok in g, su bs ta nc e ab us e, a lc oh ol a nd T hi er s se qu en t N CD s vi a so ci al m ed ia , ra di os a nd T V pr og ra m s to th e pu bl ic . M IC AT (l ea d) M oH , M oE , PI H a nd o th er re le va nt st ak eh ol de rs In te rv en ti on s M oF D P Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) M IC AT T O TA L 66 .2 22 22 .5 23 23 .5 15 7. 2 M FD P TO TA L 20 0. 6 16 7. 3 17 1. 4 17 5 17 9 89 3. 3 SO 3; S tr at eg ic 6 : A dv oc at e fo r G ra du al In cr ea se o f F in an ci al Al lo ca tio ns fo r N ut ri tio n by th e G ov er nm en t. 20 0. 6 16 7. 3 17 1. 4 17 5 17 9 89 3. 3 1. E ns ur e th at r el ev an t m in is tr ie s an d ag en ci es fo r th e de ve lo pm en t o f bu dg et li ne s fo r nu tr iti on . M FD P R EA CH a nd ot he r re le va nt st ak eh ol de rs 19 .5 19 .9 20 .4 20 .9 21 .3 10 2 2. S up po rt to in cr ea se m ul ti se ct or al fin an ci al in ve st m en t f or n ut ri tio n by a ll st ak eh ol de rs (t hr ou gh ro un dt ab le s, fu nd in g st ra te gi es ). M FD P R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 144 In te rv en ti on s: S U N C SA L Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) SN C SA L To ta l 80 9. 80 65 4. 50 75 4. 30 68 4. 90 67 6. 90 3, 58 0. 40 SO , 1 ; S tr at eg y 1: A do pt C om m un ity H ea lth In iti at iv es to r ol l o ut th e In te gr at ed M an ag em en t o f A cu te M al nu tr iti on (I M AM ) a t h ea lth fa ci lit ie s an d co m m un ity le ve ls 21 .6 22 .1 22 .6 23 .2 0 89 .5 1. A dv oc at e fo r in cr ea se d re so ur ce al lo ca tio n fo r IM AM im pl em en ta tio n in cl ud in g co m m od iti es , e qu ip m en t, H R S U N C SA L (le ad ) U N IC EF , W H O , RE AC H a nd ot he r re le va nt st ak eh ol de rs 21 .6 22 .1 22 .6 23 .2 0 89 .5 SO 3 ; S tr at eg y 1: R ev ie w , u pd at e an d /o r fo rm ul at e le gi sl at io n, g ui de lin es , st an da rd s an d co de o f p ra ct ic e on fo od q ua lit y an d sa fe ty . 19 .5 0 0 0 0 19 .5 2. E st ab lis h a co or di na tio n m ec ha ni sm fo r en ga ge m en t in nu tr iti on r eg ul at or y pr oc es s S U N C SA L U N IC EF , W H O , W FP a nd ot he r re le va nt st ak eh ol de rs 19 .5 0 0 0 0 19 .5 SO 3 ;S tr at eg y 4: In te gr at e N ut ri tio n G oa ls in to N at io na l D ev el op m en t Pl an s, S ec to ra l P ol ic ie s/ Pl an s, Pr og ra m s an d Pr oj ec ts . 16 2. 2 11 6. 1 16 9. 6 12 1. 4 12 4. 2 69 3. 4 3. N eg ot ia te w ith n at io na l au th or iti es to e na ct la w s, d ev el op nu tr iti on p ol ic ie s an d gu id el in es th at pr om ot e nu tr iti on , f oo d se cu ri ty a nd sa fe ty o f f oo d at a ll le ve ls . S U N C SA L (le ad ), M oH W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 48 .6 0 50 .8 0 0 99 .4 4. E nh an ce r ep re se nt at io n of nu tr iti on a t o th er s ec to ra l f or um s S U N C SA L W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 145 5. S up po rt d ev el op m en t a nd pr og re ss re vi ew o f a nn ua l w or kp la ns an d ot he r m ul ti ye ar p la ns a nd po lic ie s S U N C SA L W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 48 .6 49 .7 50 .8 52 53 .2 25 4. 2 6. D ev el op a nd d is se m in at e an nu al re po rt s S U N C SA L W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 SO 3; S tr at eg ic 6 : A dv oc at e fo r G ra du al In cr ea se o f F in an ci al Al lo ca tio ns fo r N ut ri tio n by th e G ov er nm en t. 56 9. 7 51 6. 3 56 2. 1 54 0. 3 55 2. 7 27 41 .2 7. A dv oc at e fo r th e ow ne rs hi p an d in st itu tio na liz at io n of th e SU N Se cr et ar ia t a t t he h ig he st le ve l i n go ve rn m en t S U N C SA L, M SP R EA CH a nd ot he r re le va nt st ak eh ol de rs 32 .5 0 0 0 0 32 .5 10 . A dv oc at e w ith H ou se s of Re pr es en ta tiv e an d Se na te , C ab in et M in is te rs a nd e sp ec ia lly M in is tr y of F in an ce to p la ce n ut ri tio n at th e he ar t o f n at io na l d ev el op m en t. S U N C SA L R EA CH a nd ot he r re le va nt st ak eh ol de rs 17 .9 18 .3 18 .7 19 .2 19 .6 93 .8 SO 4; S tr at eg y 3: D ev el op a S oc ia l Be ha vi ou r Ch an ge C om m un ic at io n St ra te gy to In cr ea se K no w le dg e an d Pr om ot e Po si tiv e N ut ri tio n Be ha vi or 36 .8 0 0 0 0 36 .8 11 . D ev el op s pe ci fic n ut ri tio n be ha vi ou ra l e du ca tio n an d co m m un ic at io n pl an fo r ke y st ak eh ol de rs p ar tic ip at in g in m ul ti se ct or s nu tr iti on s en si tiv e pr og ra m S U N C SA L U N IC EF . RE AC H , W FP , FA O , W H O a nd ot he r re le va nt st ak eh ol de rs 36 .8 0 0 0 0 36 .8 In te rv en ti on s: S U N C SA L Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) SN C SA L To ta l 80 9. 80 65 4. 50 75 4. 30 68 4. 90 67 6. 90 3, 58 0. 40 SO , 1 ; S tr at eg y 1: A do pt C om m un ity H ea lth In iti at iv es to r ol l o ut th e In te gr at ed M an ag em en t o f A cu te M al nu tr iti on (I M AM ) a t h ea lth fa ci lit ie s an d co m m un ity le ve ls 21 .6 22 .1 22 .6 23 .2 0 89 .5 1. A dv oc at e fo r in cr ea se d re so ur ce al lo ca tio n fo r IM AM im pl em en ta tio n in cl ud in g co m m od iti es , e qu ip m en t, H R S U N C SA L (le ad ) U N IC EF , W H O , RE AC H a nd ot he r re le va nt st ak eh ol de rs 21 .6 22 .1 22 .6 23 .2 0 89 .5 SO 3 ; S tr at eg y 1: R ev ie w , u pd at e an d /o r fo rm ul at e le gi sl at io n, g ui de lin es , st an da rd s an d co de o f p ra ct ic e on fo od q ua lit y an d sa fe ty . 19 .5 0 0 0 0 19 .5 2. E st ab lis h a co or di na tio n m ec ha ni sm fo r en ga ge m en t in nu tr iti on r eg ul at or y pr oc es s S U N C SA L U N IC EF , W H O , W FP a nd ot he r re le va nt st ak eh ol de rs 19 .5 0 0 0 0 19 .5 SO 3 ;S tr at eg y 4: In te gr at e N ut ri tio n G oa ls in to N at io na l D ev el op m en t Pl an s, S ec to ra l P ol ic ie s/ Pl an s, Pr og ra m s an d Pr oj ec ts . 16 2. 2 11 6. 1 16 9. 6 12 1. 4 12 4. 2 69 3. 4 3. N eg ot ia te w ith n at io na l au th or iti es to e na ct la w s, d ev el op nu tr iti on p ol ic ie s an d gu id el in es th at pr om ot e nu tr iti on , f oo d se cu ri ty a nd sa fe ty o f f oo d at a ll le ve ls . S U N C SA L (le ad ), M oH W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 48 .6 0 50 .8 0 0 99 .4 4. E nh an ce r ep re se nt at io n of nu tr iti on a t o th er s ec to ra l f or um s S U N C SA L W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 146 In te rv en ti on s : M oC I Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) M oC I T O TA L 46 3. 70 43 2. 90 41 7. 30 40 8. 00 43 7. 10 2, 15 9. 00 SO , 3 ; S tr at eg y 2: S en si tiz e an d In fo rm th e Pu bl ic a nd K ey D ec is io n M ak er s on th e Im po rt an ce o f F oo d Q ua lit y an d Sa fe ty . 22 8. 90 24 0. 70 25 2. 70 22 8. 60 26 6. 50 1, 21 7. 40 2. C on du ct jo in t v is its a t t he p or ts of e nt ry to m on ito r th e sa fe ty an d qu al ity o f i m po rt ed fo od co m m od iti es , i nc lu di ng b re as tm ilk su bs tit ut es M oH , M oC I (le ad ), N PH IL U N IC EF , W AS H , L M H , W FP , a nd ot he r re le va nt st ak eh ol de rs 21 .4 21 .9 22 .4 23 23 .5 11 2. 2 3. E ns ur e al l p ro du ct s im po rt ed to Li be ri a m us t b e la be le d in E ng lis h fo r sa fe ty o f c on su m er s M oC I ( le ad ), M oH , N PH IL , M IC AT W H O , U N IC EF , C od ex Al im en ta ri us , an d o th er re le va nt st ak eh ol de rs , M O J 40 40 .9 41 .9 42 .8 43 .8 20 9. 4 4. E ns ur e pr ot ec tio n fr om m ar ke tin g of u nh ea lth y fo od a nd b ev er ag es , m is le ad in g he al th a nd n ut ri tio n cl ai m s vi a fa ls e la be lin g S U N , M oC I (le ad ), N PH IL , M IC AT , M oH , N CC U N IC EF , W H O , a nd ot he r re le va nt st ak eh ol de rs 50 .0 0 60 .0 0 50 .0 0 40 .0 0 70 .0 0 27 0 4. E nh an ce r ep re se nt at io n of nu tr iti on a t o th er s ec to ra l f or um s S U N C SA L W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 10 . C on du ct q ua lit y co nt ro l o f fo rt ifi ed fo od s th ro ug h re gu la r m on ito ry a t a ll le ve ls o f t he fo od va lu e ch ai n. M oC I N at io na l F oo d Fo rt ifi ca tio n Al lia nc e / M oC I/ N SL , G oL a nd ot he r re le va nt st ak eh ol de rs 9. 5 9. 7 10 10 .2 10 .4 49 .8 147 6. M on ito r an d in st itu te r ep or tin g an d fe ed ba ck m ec ha ni sm fo r co ns um er s to r ep or t d is sa tis fa ct io n an d re co m m en da tio ns r el at in g to fo od s af et y. M oC I U N IC EF a nd ot he r re le va nt st ak eh ol de rs 10 0 10 0 12 0 10 4 11 0 53 4 SO 3; S tr at eg y 8: P ro m ot e Pu bl ic Pr iv at e Pa rt ne rs hi ps in N ut ri tio n Pr og ra m m in g 18 6. 2 19 2. 2 16 4. 6 17 9. 4 17 0. 6 89 3 7. P ro m ot e he al th y bu si ne ss ne tw or k w ith P ub lic P ri va te p ar tn er s fo r nu tr iti on . M oC I G oL a nd ot he r re le va nt st ak eh ol de rs 14 0 14 5 11 6. 4 13 0 12 0 65 1. 4 8. L in ke d up w ith r el ev an t m in is tr ie s to e ns ur e th at p ri va te s ec to rs liv e up to th ei r co rp or at e so ci al re sp on si bi lit ie s re la tin g to n ut ri tio n in o rd er to s av e th e liv es o f c hi ld re n. M oC I G oL a nd ot he r re le va nt st ak eh ol de rs 23 .1 23 .6 24 .1 24 .7 25 .3 12 0. 8 9. E ng ag e pa rt ne rs hi ps w ith pr iv at e co m pa ni es in vo lv ed in fo od p ro ce ss in g to e nc ou ra ge lo ca l nu tr iti ou s fo od p ro du ct io n an d fo rt ifi ca tio n of c om pl em en ta ry fo od . M oC I G oL a nd ot he r re le va nt st ak eh ol de rs 23 .1 23 .6 24 .1 24 .7 25 .3 12 0. 8 SO 3; S tr at eg y 3: S tr en gt he n In st itu tio na l C ap ac ity to E ns ur e th e M on ito ri ng a nd E nf or ce m en t o f Fo od , S an ita ry a nd P hy to sa ni ta ry St an da rd s. C on su m er E du ca tio n, Pr ot ec tio n an d pu t i n pl ac e sy st em s fo r co ns um er s to E xp re ss G ri ev an ce s an d M ak e Su gg es tio ns fo r Im pr ov em en t i n Fo od S af et y 18 6. 2 19 2. 2 16 4. 6 17 9. 4 17 0. 6 89 3 5. C on du ct tr ai ni ng to s tr en gt he n th e ca pa ci ty o f I ns tit ut io ns a nd fr on tli ne s ta ff o n fo od s an ita ry a nd ph yt os an ita ry s ta nd ar ds M oC I U N IC EF a nd ot he r re le va nt st ak eh ol de rs 48 .6 0 0 0 0 48 .6 In te rv en ti on s : M oC I Re sp on si bl e En ti ti es Su pp or ti ng En ti ti es Co st 2 02 4 (in 0 00 , U SD ) Co st 2 02 5 (in 0 00 , U SD ) Co st 2 02 6 (in 0 00 , U SD ) Co st 2 02 7 (in 0 00 , U SD ) Co st 2 02 8 (in 0 00 , U SD ) T O TA L (in 0 00 , U SD ) M oC I T O TA L 46 3. 70 43 2. 90 41 7. 30 40 8. 00 43 7. 10 2, 15 9. 00 SO , 3 ; S tr at eg y 2: S en si tiz e an d In fo rm th e Pu bl ic a nd K ey D ec is io n M ak er s on th e Im po rt an ce o f F oo d Q ua lit y an d Sa fe ty . 22 8. 90 24 0. 70 25 2. 70 22 8. 60 26 6. 50 1, 21 7. 40 2. C on du ct jo in t v is its a t t he p or ts of e nt ry to m on ito r th e sa fe ty an d qu al ity o f i m po rt ed fo od co m m od iti es , i nc lu di ng b re as tm ilk su bs tit ut es M oH , M oC I (le ad ), N PH IL U N IC EF , W AS H , L M H , W FP , a nd ot he r re le va nt st ak eh ol de rs 21 .4 21 .9 22 .4 23 23 .5 11 2. 2 3. E ns ur e al l p ro du ct s im po rt ed to Li be ri a m us t b e la be le d in E ng lis h fo r sa fe ty o f c on su m er s M oC I ( le ad ), M oH , N PH IL , M IC AT W H O , U N IC EF , C od ex Al im en ta ri us , an d o th er re le va nt st ak eh ol de rs , M O J 40 40 .9 41 .9 42 .8 43 .8 20 9. 4 4. E ns ur e pr ot ec tio n fr om m ar ke tin g of u nh ea lth y fo od a nd b ev er ag es , m is le ad in g he al th a nd n ut ri tio n cl ai m s vi a fa ls e la be lin g S U N , M oC I (le ad ), N PH IL , M IC AT , M oH , N CC U N IC EF , W H O , a nd ot he r re le va nt st ak eh ol de rs 50 .0 0 60 .0 0 50 .0 0 40 .0 0 70 .0 0 27 0 4. E nh an ce r ep re se nt at io n of nu tr iti on a t o th er s ec to ra l f or um s S U N C SA L W FP / R EA CH , Ir is h Ai d, a nd ot he r re le va nt st ak eh ol de rs 32 .5 33 .2 34 34 .7 35 .5 16 9. 9 10 . C on du ct q ua lit y co nt ro l o f fo rt ifi ed fo od s th ro ug h re gu la r m on ito ry a t a ll le ve ls o f t he fo od va lu e ch ai n. M oC I N at io na l F oo d Fo rt ifi ca tio n Al lia nc e / M oC I/ N SL , G oL a nd ot he r re le va nt st ak eh ol de rs 9. 5 9. 7 10 10 .2 10 .4 49 .8 148