Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022

MINISTRY OF HEALTH Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 © Ministry of Health, 2020 Suggested citation: Government of Kenya, Ministry of Health (2020): The Kenya Nutrition Monitoring and Evaluation Framework, 2018 –2022 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 i The development of the M & E Framework 2018-2022 was done through a consultative process of all the stakeholders in the nutrition specific and nutrition sensitive sectors. The framework is based on the review and input from various documents in the health sector namely: The National Food and Nutrition Security Policy 2011, Kenya Nutrition Action Plan 2018- 2022, Nutrition Monitoring and Evaluation Framework 2013 among others. The framework is also aligned to the Kenya Health Information System (HIS) with focus on strengthening nutrition indicators and information systems. The M&E framework offers clarity on: What is to be monitored and evaluated; who is responsible; when M & E activities are planned and carried out. The framework contains a comprehensive M&E guidance, associated indicators and toolkits and provides a harmonized approach and understanding of nutrition M&E. The framework also provides a benchmark for planning, budgeting, reporting and re-strategizing of nutrition interventions at national and county levels. Additionally, the framework will ensure continuous tracking of progress, documentation of lessons learned and replication of best practices as outlined in the KNAP 2018 2022. Dr. Patrick Amoth Ag. DIRECTOR GENERAL FOR HEALTH FOREWORD Good nutrition is fundamental for achieving right to health, embodied in article 43 in the Kenya Constitution, 2010. Therefore, the Kenya Health Policy 2014-2030 has prioritized implementation of essential nutrition actions under most of its strategic objectives. Further, nutrition has been identified as one of the essential health services under the primary health care, key driver in the realization of Universal Health Coverage envisioned in the Big Four Agenda. The Ministry is implementing the Kenya Nutrition Action Plan (KNAP) 2018-2022 whose objective is to accelerate and scale up efforts towards the elimination of malnutrition. KNAP identified Monitoring, Evaluation, Accountability and Learning (MEAL) as the mechanism that will facilitate tracking and evaluation of performance of KNAP implementation. Therefore, the Kenya Nutrition Monitoring and Evaluation (M&E) Framework 2018 2022 has been developed to serve this purpose and provides further guidance on M&E, strengthening of multi-sectoral nutrition information systems (NIS), learning and research for actors engaged in the implementation of the KNAP at the National, County and sub-county levels. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022ii The Kenya Nutrition Monitoring and Evaluation Framework has been developed through leveraging a broad range of expertise from government and partner organizations who are members of various nutrition programmes technical working groups under the Division of Nutrition and Dietetics (DND) in the Ministry of Health (MOH) Nutrition Information technical working group (NITWG), National Micronutrient Deficiency Control Committee (NMDCC), Food and Nutrition Linkages Working Group, Nutrition Capacity Development TWG and Nutrition Advocacy and Communication TWG. Sincere gratitude to United Nations Children’s Fund (UNICEF), Kenya Office for the technical leadership and financial support of the entire process which consisted of the Nutrition M&E system review and development of the M&E framework 2018-2022. Special thanks to the NITWG and the Nutrition M&E Framework Task Force under the leadership of Lucy Kinyua (MOH), Samuel Murage (MOH), Lucy Maina-Gathigi (UNICEF), Chirchir Kibet (UNICEF) and Lillian Kaindi (ACF), for ensuring completion of the development of the Framework. Special appreciation goes to the National Nutrition Technical Forum and the Nutrition Interagency Coordinating Committee (NICC) under the leadership of Veronica Kirogo (MOH) for overall technical oversight and validation. The following organizations are gratefully acknowledged for their technical support: Action Against Hunger (ACF), Feed The Children, Kenya Red Cross Society (KRCS), World Vision Kenya (WVK), Nutrition International (NI), Save The Children, Kenya Medical Research Institute (KEMRI), Kenyatta National Hospital (KNH), Ministries (Education; Water and Sanitation; Labour and Social Protection; and Agriculture, Livestock, Fisheries & Cooperatives). The contribution of all the 47 Counties through the respective County Nutrition Coordinators (CNCs) during the development and validation of the Framework is gratefully acknowledged. Lastly, special appreciation to Dr. David Soti (MOH), Leila Akinyi (MOH), Lucy Kinyua (MOH), Lucy Maina Gathigi (UNICEF) for carrying out the final editing of the framework. Dr. Pacifica Onyancha Ag. Director Medical Services, Prevention and Promotive Health ACKNOWLEDGEMENT Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 iii FOREWORD i ACKNOWLEDGEMENTS ii CONTENTS iii LIST OF TABLES v LIST OF FIGURES v LIST OF ABBREVIATIONS vi OPERATIONAL DEFINITION OF TERMS ix EXECUTIVE SUMMARY x CHAPTER 1: INTRODUCTION 1 1.1 Nutrition Status 2 1.2 Vision, Mission and Mandate of Division of Nutrition and Dietetics 5 1.3 Core Values and Guiding Principles 6 1.4 The Kenya Nutrition Action Plan 2018-2022 6 1.5 County Nutrition Action Plans (CNAPs) 2018-2022 7 1.6 Process of Development of Monitoring and Evaluation Framework 2018-2022 7 CHAPTER 2: DEVELOPMENT OF THE NATIONAL NUTRITION MONITORING AND EVALUATION FRAMEWORK 10 2.1 Rationale 11 2.2 Goal and Objectives of the M&E Framework 11 2.2.1 Goal 11 2.2.2 Objectives 11 2.3 Guiding Principles 12 2.4 Components of the Nutrition Information System (NIS) 12 2.5 Sources of nutrition data and information 13 2.6 Nutrition Information System (NIS) and M&E Toolkit 14 2.7 Data analysis 14 2.8 Data Dissemination 15 2.9 Basic Concepts of Monitoring, Evaluation, Accountability and Learning (MEAL) 15 CHAPTER 3: NUTRITION M&E FRAMEWORK IN KENYA 19 3.1 Common Results Accountability Framework 20 3.2 Indicators by Key Result Areas 22 3.3 Monitoring and Reporting 42 3.4 Monitoring and Evaluation Implementation Matrix 44 3.5 Evaluation 55 3.6 Accountability and Learning 56 3.7 Operational Research 58 3.8 Research and Learning Implementation Matrix 59 CONTENTS ACKNOWLEDGEMENT Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022iv CHAPTER FOUR: IMPLEMENTATION STRATEGY FOR THE M&E FRAMEWORK 64 4.1 Roles and Responsibilities of Stakeholders 65 4.2 Technical Coordination Mechanisms 69 4.2.1 Nutrition Information Technical Working Group 69 4.2.2 Research in Nutrition Technical Working Group (RNTWG) 69 4.3 Capacity Development for Nutrition Information and M&E 70 4.3.1 Systemic capacity for M and E 70 4.3.2 Organizational capacity 70 4.3.3 Technical capacity 71 4.3.4 Community capacity 72 4.4 Data Quality Assurance 72 4.5 Funding of the M&E system 73 4.5.1 Advocacy for nutrition information and M&E 73 4.5.2 Costing 73 4.6 Accountability: Feedback and Response mechanisms 74 4.7 Updating of the Framework 74 BIBLIOGRAPHY 75 ANNEXES 77 Annex 1: Nutrition indicators thresholds 78 Annex 2 Indicator Compendium 79 Annex 2.1 Anthropometric measurements 79 Annex 2.2 Indicators to assess for MNPs programmes coverage in population-based surveys 83 Annex 2.3 Indicators to assess IFAS programmes 86 Annex 2.4 Key Indicators for VAS 90 Annex 2.5 Indicators for Mother Infant and Young child feeding practices (MIYCN) 93 Annex 2.6 Community Health Volunteers 101 Annex 3 Good Practice Template 102 Annex 4 Research Proposal Guide Technical Working Group 103 Annex 5 Monitoring and Evaluation products and Feedback mechanisms 104 Annex 6 Formats for presenting reports for Annual work Plans 105 Annex 7 Detailed cost of Monitoring and Evaluation Framework 106 Annex 8 List of contributors 110 CONTENTS Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 v CONTENTS LIST OF TABLES Table 1: Prevalence of micronutrient deficiencies among Children(6-59 months) and Women (15-49 years) 4 Table 2: Common Results Accountability Framework: KNAP Adopted Nutrition Targets by 2022 20 Table 3: KRA 1 (Outcome 1) Indicators 23 Table 4: KRA 2 (Outcome 2) Indicators 24 Table 5: KRA 3 (Outcome 3) Indicators 25 Table 6: KRA 4 (Outcome 4) Indicators 26 Table 7: KRA 5 (Outcome 5) Indicators 27 Table 8: KRA 6 (Outcome 6) Indicators 28 Table 9: KRA 7 (Outcome 7) Indicators 28 Table 10: KRA 8 (Outcome 8) Indicators 30 Table 11: KRA 9 (Outcome 9) Indicators 31 Table 12: KRA 10 (Outcome 10) Indicators 32 Table 13: KRA 11 (Outcome 11) Indicators 33 Table 14: KRA 12 (Outcome 12) Indicators 33 Table 15: KRA 13 (Outcome 13) Indicators 34 Table 16: KRA 14 (Outcome 14) Indicators 34 Table 17: KRA 15 (Outcome 15) Indicators 35 Table 18: KRA 16 (Outcome 16) Indicators 36 Table 19: KRA 17 (Outcome 17) Indicators 38 Table 20: KRA 18 (Outcome 18) Indicators 40 Table 21: KRA 19 (Outcome 19) Indicators 41 Table 22: Monitoring and Evaluation Implementation Matrix 44 Table 23: Research and Learning Implementation Matrix 59 Table 24: Roles and Responsibilities of stakeholders in the M&E 66 Table 25: Cost of the M&E framework Implementation 74 LIST OF FIGURES Figure 1:Prevalence of Stunting in Kenya 2 Figure 2: Prevalence of wasting in Kenya 2 Figure 3: Prevalence of Obesity in Kenya 3 Figure 4: Micronutrient deficiencies among children and women 3 Figure 5: Results Logical Pyramid of the KNAP 6 Figure 6:Components of Nutrition Information System 13 Figure 7: Sources of Nutrition Information and Dissemination platforms 14 Figure 8: M&E Logical Framework 15 Figure 9: Reporting cycle of routine data-KHIS 43 Figure 10: Learning Cycle 58 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022vi LIST OF ABBREVIATIONS ACSM Advocacy, Communication and Social Mobilization AFI Acute Food Insecurity AMN Acute Malnutrition AMNR Annual Multi-Stakeholder Nutrition Reviews ASAL Arid and Semi-Arid Lands BMI Body Mass Index CDs Computer Disks CECM County Executive Committee Member CHIS Community Health Information System CHMT County Health Management Team CHS Community Health Strategy CHSSIP County Health Sector Strategic and Investment Plan CHV Community Health Volunteer CNAP County Nutrition Action Plan CNC County Nutrition Coordinator CNTF County Nutrition Technical Forum CoG Council of Governors CRAF Common Results and Accountability Framework CUs Community Units DND Division of Nutrition and Dietetics DNCD Division of Non-Communicable Diseases DHIS District Health Information System DQA Data Quality Assurance EML Essential Medicines List ETR End term Review EWS Early Warning System FAO Food and Agriculture Organization FEWSNET Famine Early Warning Systems Network FCS Food Consumption Score FNSP Food and Nutrition Security Policy (FSNP) GAIN Global Alliance for Improved Nutrition GBD Global Burden of Disease GDP Gross Domestic Product GNR Global Nutrition Report HDSS Health and Demographic Surveillance System HIS Health Information System HIV Human Immunodeficiency Virus HMIS Health Management Information System HRH Human Resources for Health IFAS Iron Folic Acid Supplement IMAM Integrated Management of Acute Malnutrition IPC Integrated Phase Classification JFFLS Junior Farmer Field and Life School of the Ministry of Agriculture Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 vii KABP Knowledge Attitude Behavior and Practices KAP Knowledge Attitude and Practices KDHS Kenya Demographic and Health Survey KEBS Kenya Bureau of Standards KEMRI Kenya Medical Research Institute KEMSA Kenya Medical Supplies Authority KHIS Kenya Health Information System KHO Kenya Health Observatory KHSSP Kenya Health Strategic and Investment Plan KIHBS Kenya Integrated Household Budget Survey KNAP Kenya Nutrition Action Plan KNBS Kenya National Bureau of Statistics KNMS Kenya National Micronutrient Survey KRA Key Result Area KRCS Kenya Red Cross Society LMIS Logistic Management Information System LQAS Lot Quality Analysis Sampling MAM Moderate Acute Malnutrition M&E Monitoring and Evaluation MCA Member of County Assembly MCNP Maternal and Child Nutrition Program MEAL Monitoring Evaluation, Accountability and Learning MICS Multiple Indicators Cluster Survey MIYCN Maternal Infant and Young Child Nutrition MIYCN-E Maternal Infant and Young Child Nutrition-Emergency MoALC Ministry of Agriculture, Livestock and Cooperatives MDA Ministries, Departments and Agencies MNP Micronutrient Powder MODA Ministry of Devolution and ASAL MoE Ministry of Education MOH Ministry of Health MoV Means of verification MTR Mid Term Review MUAC Mid Upper Arm Circumference NASCOP National AIDS and STIs Control Programme NCD Non-Communicable Diseases NCTWG Nutrition Capacity Technical Working Group NDMA National Disaster Management Authority NGO Non-Governmental Organization NFNSP-IF National Food and Nutrition Security Policy Implementation Framework NiPN National Information Platform for Nutrition NI Nutrition International NIS Nutrition Information System LIST OF ABBREVIATIONS Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022viii NITWG Nutrition Information Technical Working Group NNAP National Nutrition Action Plan NPW Non-Pregnant Women ODK Open Data Kit OJT On Job Training OECD-DAC Organization for Economic Co-operation and Development’s (OECD) Development Assistance Committee (DAC) PC Performance Contract PL-HIV People Living With Human Immunodeficiency Virus PSC Public Service Commission RMNCAH Reproductive, Maternal, Newborn, Child and Adolescent Health RDQA Routine Data Quality Assessment RNTWG Research in Nutrition Technical Working Group SAM Severe Acute Malnutrition SDGs Standard Deviation SD Sustainable Development Goals SLEAC Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage SMART Standardized Monitoring Assessment on Relief and Transition SQUEAC Semi Quantitative Evaluation on Access and Coverage SUN Scaling Up Nutrition TB Tuberculosis ToC Theory of Change TWG Technical Working Group UN United Nations UNICEF United Nations Children Fund VAD Vitamin A Deficiency W/A Weight for Age WASH Water Sanitation and Hygiene WFP World Food Programme W/H Weight for Height WHA World Health Assembly WRA Women of Reproductive Age WVK World Vision Kenya Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 ix Term Operational Definition Stakeholders Refers to a group of agencies or persons with a similar interest in a particular field e.g. nutrition. Research Refers to the generation of knowledge that can be used to prevent disease, promote, restore, maintain, protect and improve the population’s development and well-being. Surveys Periodic, focused assessments that collect data from a population. Surveys are used to assess the perceptions, behaviour, knowledge, attitudes and infection status of targeted populations Surveillance Ongoing, systematic collection, collation, analysis and interpretation of trends and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health. Nutrition surveillance is a systematic approach used to detect malnutrition and identify populations at risk of suffering from it for action. Relevance Only data that meets the information needs is collected, to inform project management and decision-making. Data captured should be used for the purposes for which it is collected. Validity Data use should be able to measure the changes being tracked. Data should be recorded and used in compliance with relevant requirements, including the correct application of any rules or definitions. This will ensure consistency between periods and with similar activities. Where proxy data is used to compensate for an absence of actual data, activities must consider how well this data is able to satisfy the intended purpose Accuracy Data should represent the actual population and their situation. Data should be sufficiently accurate for its intended purposes, representing clearly and in sufficient detail the interaction provided at the point of activity Completeness Data requirements should be clearly specified based on the information needs of the activities and data collection processes matched to these requirements Reliable Data should be verifiable, producing the same results when used repeatedly to measure the same thing over time. Data should reflect stable and consistent data collection processes across collection points and over time, whether using manual or computer based systems, or a combination Timeliness Data should be captured as quickly as possible after the event or activity and must be available for the intended use within a reasonable period. Data must be available quickly and frequently enough to support information needs and to influence the appropriate level of service or management decisions OPERATIONAL DEFINITION OF TERMS Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022x Kenya is facing a triple burden of malnutrition in the form of under nutrition, micronutrient deficiencies and over-nutrition. The Ministry of Health in collaboration with stakeholders developed the Kenya Nutrition Action Plan (KNAP) 2018-2022. The overarching objective of the plan is accelerating and scaling up efforts towards the elimination of malnutrition in Kenya in line with Kenya’s Vision 2030 and Sustainable Development Goals (SDGs) with focus on specific achievements by 2022. The action plan is organized into three category focus areas namely; Nutrition-specific and Nutrition-sensitive Interventions and, Enabling Environment. The Kenya Nutrition Monitoring and Evaluation Framework 2018-2022 has been developed to align with the needs of the Kenya Nutrition Action Plan 2018-2022. A review of the Nutrition Monitoring and Evaluation Framework 2013 and other relevant documents was conducted to inform the development of this framework. The development was conducted through a consultative process involving deliberations by task teams, stakeholder consultations, and online survey and review and validation workshops. The rationale of this framework is to ensure continuous tracking of progress, document lessons learned and replicate best practices of nutrition interventions as outlined in the KNAP 2018-2022. It highlights the goal and the objectives and the guiding principles which are expected to ensure a systematic implementation of the monitoring and evaluation framework. The framework describes the basic principles of Monitoring, Evaluation, Accountability and Learning (MEAL) the sources of nutrition information and data analysis and reporting. In addition, the Nutrition Information System monitoring toolkit repository comprising of a variety of guidelines, training packages, tools for data collection and guidance on data analysis and reporting for different sources of information has been developed to provide ease of accessibility to these tools and documents. The framework also covers the Common Results and Accountability Framework (CRAF) for the 19 Key Result Areas (KRAs) and elaborates the process of Monitoring, Evaluation, Accountability and Learning. The key result areas are categorized into nutrition specific, nutrition sensitive and enabling environment with their indicators, definitions, thresholds, means of verification, frequency of reporting and operational research to be conducted. The indicators will be measured and reported through existing systems such as Kenya Health Information System (KHIS), the National Drought Management Authority (NDMA) early warning system, program reports and population-based surveys. Reporting and communication of results will adhere to standard guidelines and use effective communication channels to ensure improved uptake of findings. Evaluation and operational research will be implemented to provide evidence for informing programme decisions that lead to effective coverage of interventions. Finally, accountability will be mainstreamed to ensure service providers or duty bearers are accountable for resources and results. Learning and application of best practices will contribute to adaptation of approaches that are known to produce results. The actualization of the M&E Framework will help build a chain of evidence that will provide the metrics of change. The burden of proof lies with the various stakeholders whose responsibility is to demonstrate that the commitment made in the KNAP 2018-2022 shall indeed be realized and that there is evidence to back up the claim of progress. The implementation strategy therefore shall be driven by human resource development and system readiness and funding mechanisms that will boost M&E human resource and systems at National and County levels. EXECUTIVE SUMMARY Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 1 INTRODUCTION CHAPTER 1 EXECUTIVE SUMMARY Kenya Nutrition Monitoring and Evaluation Framework 2018 to 20222 1.1 Nutrition Status Nutrition is a vital component in human growth and development. Globally, at least one in three people is experiencing malnutrition in one form or another. Almost every country in the world is facing a nutrition related challenge characterized by undernutrition (stunting, wasting and underweight), micronutrient deficiencies and over-nutrition (overweight/ obesity); that is triple burden of malnutrition. The 2018 Global Nutrition Report (GNR) estimates that 150.8 million children under the age of five (22.2 per cent) are stunted and 50.5 million children (7.4 per cent) are wasted. The anaemia prevalence in girls and women of reproductive age (15-49 years) remains high at 32.8 percent, having increased from 31.6 percent in 2000. Slightly over two billion adults are overweight, of whom 678 million are obese; and 38.3 million children are overweight1. In different regions, the proportion of stunting among children under the age of five has declined: for example, in Asia from 38.1 percent to 23.2 percent; Latin America and the Caribbean from 16.9 percent to 9.6 percent; and Africa from 38.3 percent to 30.3 percent. Despite the decreased prevalence of stunting in Africa, the number of stunted children increased steadily from 50.6 million in 2000 to 58.7 million in 2017. Sub-Saharan Africa (SSA) contributes the highest burden of malnutrition in Africa. There are 17.6 million children in sub Saharan Africa who suffer from acute malnutrition2. In Kenya, the situation of undernutrition is very similar to the global outlook. Out of 7.22 million children less than five years old, nearly 1.8 million are stunted (26 percent); 290,000 are wasted (4 percent) and 794,200 (11 percent) are underweight. However, there are geographical variations in the severity of malnutrition (See Figures 1, 2 and 3). Figure 1:Prevalence of Stunting in Kenya Figure 2: Prevalence of wasting in Kenya 1 2018 Global Nutrition Report 2 2018 Global Nutrition Report Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 3 The Kenya Demographic Health Survey (KDHS) 2014 showed a decline in stunting from 35.3 percent in 2008 to 26 percent in 2014 as shown in Figure 4. Though the country has made a lot of progress towards reduction of stunting, the country is classified as having high (20-<30 percent) levels of malnutrition based on the new WHO 2017 classification thresholds3. All counties in Kenya are now classified as being in medium (10 <20 percent) or high (20-<30 percent) category and need to prioritize interventions to achieve low (2.5-<5 percent) or very low <2.5 percent) levels of stunting. Stunting is very high (>30 percent) in 9 counties4. Nationally, stunting peaks at 18 23 months where 35.3 percent of the children are stunted. More boys than girls are stunted (30 percent compared to 22 percent respectively). In terms of wasting, there has been modest decline from 6.7 percent in 1993 to 4 percent in 2014 (Figure 4). Kenya is now classified in the ‘low’ category based on the new WHO thresholds. Huge disparities however exist within the country with arid counties in very high (>15 percent) category. Wasting is highest in Turkana at 23 percent and lowest at 0.2 percent in Siaya (KDHS 2014). 39.9 37.7 35.7 35.3 26 18.7 18 15.8 16.1 11 6.7 6.9 6 6.7 4 0 5 10 15 20 25 30 35 40 45 1993 DHS 1998 DHS 2003 DHS 2008-09 DHS 2014 DHS % C hi ld re n Trends in stunting underweight and wasting (WHO reference standards) Children stunted Children underweight Children wasted Figure 4: Trends in Stunting, Underweight and Wasting 1993-2014 Although the KDHS 2014 showed that poor nutrition status of women of reproductive age (WRA) was a triple burden, the trend indicated a reduction of undernutrition while overweight and obesity increased. Higher prevalence of obesity is observed in the central region of the country. Comparing the 2008–9 and 2014 KDHS, the proportion of women with a Body Mass Index (BMI) ≥18.5 reduced from 12 percent to 9 percent. 3 Annex 1: Nutrition Indicators Thresholds 4 West Pokot, Kitui, Kilifi, Samburu, Narok, Uasin Gishu, Tharaka Nithi, Mandera and Bomet Kenya Nutrition Monitoring and Evaluation Framework 2018 to 20224 Micronutrient deficiency among children and women Micronutrient deficiency not immediately evidenced by clinical symptoms affects body function and productivity of an individual. Micronutrient deficiencies of public health importance affects mainly the vulnerable sub-populations (children and women). The deficiencies can be addressed through dietary diversification, food fortification, supplementation and other public health interventions. According to the Kenya National Micronutrient Survey 2011 significant progress was made in reducing the prevalence of micronutrient deficiencies, except for zinc deficiency5. The prevalence of anaemia was highest in pregnant women (41.6 per cent), followed by children 6–59 months (26.3 per cent) and school–age children (5–14 years) at 16.5 per cent. The prevalence of iron deficiency was 21.8 per cent, 9.4 per cent and 36.1 per cent in the same groups respectively (Table 1). The prevalence of Vitamin A deficiency (VAD) had reduced considerably with preschoolers at 9.2 percent and pregnant women 4.7 percent. The prevalence of zinc deficiency was high across the population groups; 83.3 percent among all the population sub-groups; 81.6 percent among the pre-schoolers, 79.9 percent among non-pregnant women, 67.9 percent among pregnant women and 77.4 among men (Table 1). Table 1: Prevalence of micronutrient deficiencies among Children(6-59 months) and Women (15-49 years) Indicators National Prevalence n % 95% CI Pre-School Children 827 26.3 23.3 29.3 School Age Children (Children 5-14 years) 872 16.5 14.0 19.0 Pregnant Women 104 41.6 32.1 51.1 Non-pregnant Women 592 21.9 18.57 25.23 Men 240 9.3 5.87 13.33 Pre-School Children 918 21.8 19.1 24.5 School Age Children 942 9.4 7.5 11.3 Pregnant Women 111 36.1 27.2 45.0 Non-pregnant Women 633 21.3 18.11 24.49 Men 247 3.6 1.28 5.92 Pre-School Children 827 13.3 11.0 15.6 School Age Children 942 4.9 3.5 6.3 Pregnant Women 104 26.0 17.6 34.4 Non-pregnant Women 592 14.0 11.20 16.80 Men 243 2.9 0.79 5.01 Pre-School Children 918 9.2 7.3 11.1 School Age Children 942 4.7 3.4 6.1 Pregnant Women 111 5.4 1.2 9.6 Non-pregnant Women 632 2.0 0.9 3.1 Men 111 0.0 0 0 5 The Ministry of Health, Kenya National Micronutrient Survey 2011 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 5 Indicators National Prevalence n % 95% CI Pregnant Women 78 32.1 21.7 42.5 Non-pregnant Women 445 30.9 26.6 35.2 Pregnant Women 78 7.7 1.8 13.6 Non-pregnant Women 445 34.7 30.3 39.1 (Serum zinc corrected for inflammation) Pre-School Children 711 81.6 78.8 84.5 School Age Children 901 79.0 76.3 81.7 Pregnant Women 109 67.9 59.1 76.7 Non-pregnant Women 617 79.9 76.7 83.1 Men 239 77.4 72.1 82.7 School age Children 951 22.1 19.5 24.7 Non-pregnant Women 623 25.6 22.2 29.0 Source: Kenya National Micronutrient Survey, 2011 1.2 Vision, Mission and Mandate of Division of Nutrition and Dietetics The Division of Nutrition and Dietetics (DND) is in the Department of Family Health, Ministry of Health. The vision, mission and mandate of DND are as follows: Vision Malnutrition free Kenya. Mission To reduce all forms of malnutrition in Kenya using well-coordinated multi-sectoral and community-centered approaches for optimal health of all Kenyans and the country’s economic growth. Mandate The mandate includes: • Policy formulation, standards development and strategic planning; • Provision of nutrition services; • Coordination and resource mobilization; • Nutrition assessments and surveillance; • Capacity strengthening of health and other workers on food and nutrition; • Creation of awareness to the public on food and nutrition; • Procurement and distribution of equipment and supplies for nutrition service delivery; • Food and nutrition operations research; • Administration of the scheme of service for nutrition officers and assistants; and • Monitoring and evaluation of nutrition programmes. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 20226 1.3 Core Values and Guiding Principles The Division of Nutrition and Dietetics core values are: • Efficiency and Effectiveness • Accountability • Professionalism • Integrity. • Partnership • Teamwork and collaboration • Innovativeness • Ethics • Equity Quality • Risk management • Sustainability and ownership 1.4 The Kenya Nutrition Action Plan 2018-2022 The overarching objective of the KNAP 2018-2022 is to accelerate and scale up efforts towards the elimination of malnutrition in Kenya in line with Kenya’s Vision 2030 and sustainable development goals, focusing on specific achievements by 2022. The KNAP is organized into three focus areas: Nutrition-specific, Nutrition sensitive and Enabling environment. Within the three focus areas are a set of Key Results Areas (KRAs) with corresponding outcomes, outputs, strategies, interventions and activities that are costed and presented within an implementation matrix. The activities/interventions outlined in the KNAP will be implemented twith an aim to produce a series of results that contributes to the desired goal (impact) for the KNAP which is ‘All Kenyans achieve optimal nutrition for a healthier and better quality of life and improved productivity for the country’s accelerated social and economic growth’. Figure 5 depicts the results logic pyramid of the KNAP combining theory of change and logic framework approaches. The results pyramid framework ensures results-based planning, budgeting, and implementation and performance M&E, and facilitates results-based management of the KNAP. Figure 5: Results Logical Pyramid of the KNAP Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 7 A Monitoring, Evaluation, Accountability and Learning framework (MEAL) has been developed and targets put in place to measure the progress in implementation of the KNAP over the five-year period during which the KNAP will be implemented. The MEAL framework provides a summary of select results and indicators that will be mutually tracked and reported on by all sectors responsible for the implementation of the KNAP referred to as the Common Results and Accountability Framework (CRAF). The Nutrition Monitoring and Evaluation Framework will therefore provide further guidance on monitoring and evaluation and strengthen multi-sectoral nutrition information systems (NIS), learning and research for players engaged in the implementation of the KNAP at all levels. 1.5 County Nutrition Action Plans (CNAPs) 2018-2022 Counties have adopted the KNAP to develop County Nutrition Action Plans (CNAPs) that address County specific nutrition issues and interventions that are appropriate for their local context. Through these action plans, Counties will identify priority multi-sectoral nutrition actions, define targets for each intervention and cost interventions which County governments can use for subsequent planning and budgeting. More so, to ensure tracking of these activities, CNAPs will provide a monitoring and accountability framework. Based on the CNAPs and the National Nutrition Monitoring and Evaluation Framework 2018-2022, the counties will develop county level M&E frameworks for tracking of nutrition activities and results as outlined in the respective CNAPs. The M&E frameworks will be integrated in the CNAPs and the yearly M&E activities included in the County Annual Work Plans. Furthermore, mechanisms will be put in place to ensure there is linkage between national and county action plans, effective multisectoral collaboration as well as functioning stakeholder coordination and accountability. The framework will also provide for mechanisms for communication and information sharing within the county and between the two levels of government. 1.6 Process of Development of Monitoring and Evaluation Framework 2018-2022 The Nutrition Monitoring and Evaluation Framework 2018-2022 is the second after the first one which was developed in 2013. The framework is anchored on the ideals of the Kenya Food and Nutrition Security Policy (FSNP) that are unpacked in the KNAP 2018-2022.The framework was developed through a comprehensive participatory and consultative process guided by the Ministry of Health Division of Nutrition and Dietetics through the Kenya National Information Technical Working Group (NITWG). A team of Nutrition and M&E professionals from government agencies, development and implementing partners participated in the development of the framework6. The development process was preceded by a review of the existing health and nutrition M&E/information system and use of the 2013 nutrition M&E framework to identify gaps and develop recommendations to inform the process. A detailed and extensive desk review of relevant documents including policy documents, KNAP 2018-2022, National Nutrition M&E Framework 2013 was conducted. Stakeholder consultations with donors, development and implementing partners as well as county officials were conducted through Key Informant Interviews. In addition, an online survey was conducted targeting national and county government officials and technical staff in partner agencies. This M&E framework was developed through deliberations of various task review groups and validation workshops to ensure all the key M&E elements in the KNAP 2018-2022 were taken care of. The Framework builds on learning, success, limitations and opportunities of the 2012-2017 NNAP and 2013 M&E Framework period. 1.7 Status of the nutrition M&E and information system According to the M&E system review, Kenya has made commendable progress in establishing a functional nutrition information system though gaps exist especially in monitoring implementation of nutrition plans and programs at process level. The first M&E Framework was finalized in 2013 with an overall goal of guiding monitoring and evaluation of the 2012-2017 National Nutrition Action Plan and to provide quality information for effective planning, decision making, monitoring and evaluation of nutrition interventions in the country. 6 See annex 7 for list of contributors in technical review workshops. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 20228 The objectives of the framework were: • To provide guidelines on data collection, reporting, feedback and nutrition programming. • To monitor and evaluate quality of nutrition data and activities • To promote data use at all levels to inform decision making and nutrition programming • To produce and disseminate program implementation reports at all levels • To monitor the health sector’s response to nutrition • To contribute towards strengthening of the nutrition information component of health systems • To develop a supervisory framework to facilitate high quality data collection, collation, analysis, reporting and use at all levels and, • To provide a framework for the systematic linkage of nutrition and food security indicators at National and County level. Nutrition M & E is recognized as a critical function of the Division of Nutrition and Dietetics and the nutrition sector. There is a distinct program in the Division that is responsible for national and county level nutrition monitoring, evaluation, accountability and learning. The functions of the program is coordinated through the Nutrition Information Technical Working Group (NITWG). The key functions of the NITWG include: • Development of standards and guidelines for nutrition information including adoption and adaption of relevant international guidelines • Development, review and validation of nutrition data collection, procedures/ methodologies, analysis and reporting. • Produce nutrition situation reports and other information products • Data dissemination for action, maintaining an up to data nutrition information portal in the nutrition website and ensuring common repository • Capacity strengthening and technical support on nutrition information when and as needed especially to the counties • Strengthen multi-sectoral linkages on nutrition information through direct participation in various sectoral and multi-sectoral forums • Promotion of knowledge management; documentation of success and lessons learnt • Strengthen continuity of NITWG partnership with key stakeholders such as NDMA, Kenya National Bureau of Statistics (KNBS) and enhance linkages with other working groups within the sector. • Quality assurance, technical oversight and supervision. The M&E framework 2013 contributed to addressing the problem of malnutrition. It was essential for tracking the implementation of the NNAP 2012-2017 which was critical towards the improvement of nutrition outcomes. One measure of success was availability of M&E information from various sources and databases which was useful for informing decision making for programme improvement. Nutrition indicators were integrated in the monthly facility-based Kenya Health Information System (KHIS aggregate/ KHIS) and provided data on nutrition programs coverage such as vitamin A supplementation and iron & folic acid supplementation. The large-scale population-based surveys (e.g. KDHS, KNMS), the more frequent small-scale population-based surveys (e.g., Integrated nutrition SMART surveys and Integrated Management of Acute Malnutrition (IMAM) program coverage assessment) also provided information for monitoring and evaluation of nutrition programmes. The challenges of implementing the 2013 Nutrition M&E Framework and activities included: • Limited funding for M&E activities such as technical supervision, capacity development, conducting of review forums and integration of technology in the M&E systems. • Understaffing and inadequate capacity for nutrition and M&E programmes both at the national and county levels. • Gaps in technical knowledge in M&E as a result of inadequate capacity development and technical supervision. • Inefficient M&E practices such as delayed dissemination of information and inadequate utilization of data. • Inadequate stakeholder co-ordination and accountability mechanisms Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 9 Recommendations from the review of the NIS/ M&E system: In summary the following recommendations were made as the major considerations for the development of the M&E framework 2018-2022: • Strengthening and improving the quality of the KHIS data, in terms of comprehensiveness, reporting and utilization. • Strengthen the evaluation of the KNAP 2018-2022 by including mid-term and end-term reviews and operational research to track the progress and performance of the KNAP and inform programming. • Improve implementation of the M&E system and NIS by improving multi-sectoral coordination, technical supervision, capacity building on M&E and NIS, dissemination and utilization of M&E data. • Put in place a central repository for all NIS tool/kit for easy accessibility. • Emphasize the use of technology in M&E such as digitalize trainings (online trainings on NIS and M&E), dissemination and review of M&E data processes. • Improve and strengthen Advocacy, Communication and Social Mobilization (ACSM) to lobby for profiling and funding for nutrition programmes and M&E. • Strengthen stakeholder co-ordination and accountability mechanisms at national and county levels These gaps and challenges identified during the M&E system review and the resulting recommendation necessitates development of the 2018-2022 Nutrition M&E Framework while taking into consideration the key lessons learnt, field experiences, emerging knowledge and alignment to the 2018-2022 KNAP. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202210 DEVELOPMENT OF THE KENYA NUTRITION MONITORING AND EVALUATION FRAMEWORK CHAPTER 2 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 11 2.1 Rationale Kenya has numerous nutrition stakeholders including government ministries, development agencies, implementing partners, teaching and research institutions, nutrition working groups and professional associations, as well as the private sector. However, even with many players in nutrition, there has been sub-optimal impact, from implementation of high impact nutrition interventions. This, in part, is attributed to challenges arising from coordination ofnutrition programs in different sectors, the short-term nature of interventions which mainly target emergency situations and inadequate holistic programming leading to interventions with limited scope and impact. These challenges call for sector-wide approaches to nutrition programming in the country in order to meet the SDGs. In this regard, the Kenya Nutrition Action Plan 2018-2022 was developed to further accelerate and scale up efforts towards the elimination of malnutrition as a problem of public health significance in Kenya by 2030, focusing on specific achievements by 2022. The main purpose of the M&E framework is to ensure continuous tracking of progress, document lessons learned and replicate best practices of nutrition interventions as outlined in the KNAP 2018-2022. Monitoring and evaluation will be an integral part of all aspects of the nutrition interventions. The framework is aligned to the Health Information System (HIS) with focus on strengthening nutrition indicators and systems. Chapter 6 of the KNAP 2018-2022 broadly defined Monitoring, Evaluation, Accountability and Learning (MEAL) which will facilitate tracking and evaluation of performance, as well as serving as an accountability and learning framework for the various nutrition stakeholders. The M&E framework will provide further guidance on monitoring and evaluation of the KNAP 2018-2022 and Nutrition Information Systems (NIS). The framework will serve as a plan for monitoring and evaluation and will clarify: 1. What is to be monitored and evaluated; 2. What activities need to be monitored and evaluated; 3. Who is responsible for monitoring and evaluation of the activities; 4. When monitoring and evaluation activities are planned; and 5. How monitoring and evaluation will be carried out. The framework will put in place a comprehensive guidance and a harmonized approach to nutrition information management, monitoring and evaluation. The Framework will enable real time improvement; identify unintended consequences; facilitate the learning of best practices and communication of results. The outputs of the M&E system will help to answer questions relating to delivering on commitments, accountability to right-holders, donors and other players, effectiveness of interventions and consistency of planned interventions with targets. The framework will define progress review and feedback mechanism for results-based accountability between the national and county levels and provide guidance on data collection, analysis, use and reporting of nutrition information for improved programming. 2.2 Goal and Objectives of the M&E Framework 2.2.1 Goal The goal of the Monitoring and Evaluation Framework is to ensure a systematic monitoring and evaluation of nutrition sector activities in Kenya in line with the Key Result Areas (KRAs) as derived from the Kenya Nutrition Action Plan 2018-2022 and serve as an accountability and learning framework for nutrition stakeholders. 2.2.2 Objectives • To provide guidelines on data collection, reporting, feedback and use for nutrition programmes. • To monitor and evaluate quality of nutrition data and activities. • To facilitate tracking and evaluation of performance of set targets • To produce and promote data for use at all levels to inform decision making and nutrition programming. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202212 • To produce and disseminate programmes implementation reports at all levels. • To monitor the health sector’s response to nutrition. • To contribute towards strengthening of the nutrition information component of health systems. • To develop a supervisory framework to facilitate high quality data collection, collation, analysis, reporting and use at all levels. • To strengthen the operational research capacity and coordination mechanism at national and county levels to generate evidence to inform decision making. • To provide a framework for the systematic linkage of nutrition and food security indicators at national and county levels. • Rally partners and stakeholders to a common approach to reporting • To provide an accountability and learning framework for the various nutrition stakeholders both at national and county levels. 2.3 Guiding Principles The M&E framework is guided by the following principles: 1. Three Ones Principle: a. One national coordinating authority, with a broad-based multi-sector mandate. b. One agreed comprehensive Kenya nutrition plan of action. c. One agreed country level nutrition monitoring and evaluation framework. 2. Mainstreaming of M&E in all nutrition interventions at all levels. 3. Decentralization, analysis and storage of data at the operational level. 4. Gender and disability mainstreaming, attention to vulnerable groups and regional disparities. 5. Participatory approach; consultation of key stakeholders for ownership and use. 6. Adherence to national, regional and global standards and M&E ethics. 7. Integration and complementarity to existing M&E systems where new data collection may be required or recommended. 8. Efficient use of resources while ensuring quality M&E products are generated. 9. Review and validation of the M&E products through the existing relevant structures. 2.4 Components of the Nutrition Information System (NIS) NIS is a system of continuous collection, analysis and interpretation of nutrition-related data for making timely and effective decisions to improve the nutritional health of the population. It requires the availability of, access to, and analysis of accurate and adequate information that address national, sub-national and institutional development as well as implementation challenges. NIS comprises of several components (Figure 6): Resources: These include the legislative, regulatory, and planning frameworks required for system functionality and also include personnel, financing, logistics support, information and communications technology (ICT), and mechanisms for coordinating both within and between the components. Indicators: This includes a complete set of indicators and relevant targets, including inputs, outputs, and outcomes, determinants of health and nutrition, and nutrition status indicators. Data sources: These include population-based surveys, sentinel surveillance systems, routine administrative data among others Data management: This includes collection and storage, quality assurance, processing and flow, and compilation and analysis. Information products: This refers to data which has been analyzed and presented as actionable information. Dissemination and use: This is the process of making data available to decision-makers and facilitating the use of that information. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 13 Figure 6: Components of Nutrition Information System 2.5 Sources of nutrition data and information Nutrition programs draws data and information from direct sources as well as from other information systems within and outside the health sector (Figure 7). The main nutrition data and information sources include: 1. Routine data collected through the Health Information System (HIS). This includes data from KHIS, Logistic Management Information System (LIMIS), Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) scorecard and Nutrition scorecard. 2. Population based data includes large scale surveys such as Kenya Demographic and Health Survey, Kenya Integrated Household Budget Survey (KIHBS), Kenya National Micronutrient Survey, Multiple Indicator Cluster Surveyand small scale surveys such as Integrated nutrition SMART surveys, Maternal Infant and Young Child (MIYCN) Knowledge, Attitudes and Practices (KAP) assessments, MIYCN-E rapid assessments and IMAM program coverage surveys among others. 3. NDMA Early Warning System - Sentinel Surveillance 4. Joint Food Security and Nutrition Seasonal Assessments including situation analysis with Integrated Phase Classification for acute malnutrition and food Insecurity (IPC AMN and AFI) protocols. 5. Mass screening data 6. Special studies and operational researches 7. Project and program reports 8. Nutrition capacity assessment conducted to assess system capacity to deliver nutrition services 9. The online food fortification database 10. The Kenya Nutrition Website7, 11. The interactive Population Based Survey Database8 12. The multisectoral National Information Platform for Food and Nutrition (NiPFN)9. 7 www.nutritionhealth.or.ke 8 http://www.nutritionhealth.or.ke/nutrition-reports-on-maps/ 9 NiPFN is Under development 7 www.nutritionhealth.or.ke 8 http://www.nutritionhealth.or.ke/nutrition-reports- on maps/ 9 NiPFN is Under development Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202214 Figure 7: Sources of Nutrition Information and Dissemination platforms Routine data KHIS, LMIS, RMCAH scorecard and Nutrition scorecard. NDMA EWS, joint Food Security and Nutrition Seasonal Assessments including IPC AMN and AFI. Program reports Special studies and operational researches Nutrition capacity assessment Online food fortification database Dissemination platforms: nutrition website, population based survey database, NiPN Mass screening data Small scale surveys: SMART surveys, MIYCN KAP, MIYCN-E rapid assessments, IIMAM program coverage assessment Large scale surveys: KDHS, KIHBS, KNMS MICS 2.6 Nutrition Information System (NIS) and M&E Toolkit Standardized tools and methods of collection are essential to ensure that the data generated within the NIS/ M&E is of good quality. When utilized in a systematic and coordinated manner, these resources help to ensure that indicators are comparable across counties and achieve compatible degrees of disaggregation. Updated training materials, technical guidelines, manuals, forms, registers and report template used in the NIS have been consolidated in a toolkit to allow easy access and are uploaded on the nutrition website (http://www. nutritionhealth.or.ke/resources/). 2.7 Data analysis Nutrition data from the various sources will be analyzed for use in decision making at all levels of the health system. Analysis will involve systematic data quality assessment and if necessary, adjustment will be done where appropriate. Identifying and accounting for biases because of incomplete reporting, inaccuracies and non-representatives are essential measures and will greatly enhance the credibility of the results for users. The analyses will be transparent and in line with national data analysis standards. The data will be analyzed by comparing achievements against the set targets or baselines (as well as with international standards e.g. SPHERE standards and MOH guidelines/standards (Annex 1). Analysis will also be done by establishing if the implementations of activities in the nutrition action plan have been conducted to determine whether progress is being made and inform the required adjustment. Data analysis will also be conducted to compare trends of the nutrition situation and interventions at various levels over time. Nutrition information analysis will be complemented by more complex analyses that provide estimates of the burden of malnutrition, nutrition service coverage, trends in nutrition indicators, and health system performance. In addition, use of nutrition research as well as qualitative data gathered through systematic processes of analyzing nutrition systems characteristics and changes will be considered. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 15 2.8 Data Dissemination Data and information dissemination refer to targeted distribution of information to a specific audience. It is the process of transfer of data between users with the intention of spreading knowledge and the associated evidence-based interventions for use in policy development, decision making, and programming. Analyzed information will be disseminated through technical forums and meetings, bulletins, quarterly and annual reports and the nutrition website (http://www.nutritionhealth.or.ke/). To ensure effective dissemination use of visuals and dashboards will be employed. Analyzed nutrition information presented in a precise and visual manner is anticipated to enhance: • The use of information for planning, • Re-strategizing of programme activities, • Forming conclusions and anticipating how to deal with problems, • Replicating best practices, • Accountability, • Advocacy • Documentation of lessons learnt and • Documentation of Human-interest stories. 2.9 Basic Concepts of Monitoring, Evaluation, Accountability and Learning (MEAL) The logical framework identifies and illustrates the linear relationships flowing from program inputs, processes, outputs, outcomes and impacts. Inputs or resources affect processes or activities which produce immediate results or outputs, ultimately leading to long term or broad results, or outcomes and impacts. Indicators are used to measure performance of programs at different levels. Inputs, processes and outputs are regularly monitored while outcomes and impact are periodically assessed either through surveys or evaluations. The M&E framework will demonstrate to stakeholders to what extent results have been achieved according to priorities in plans and establish a process through which information generated is reflected upon and intentionally used to continuously improve the implementation of the KNAP. Nutrition programs has adopted a basic M & E logical framework as illustrated in figure 8. Figure 8: M&E Logical Framework Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202216 Inputs: Refer to all those resources that go into the nutrition programs at the onset or start-up phase or during the implementation to help the programs achieve their objectives as stipulated in KNAP and CNAPs. The inputs include human resources, financial resources for conducting various activities. Adequate inputs are critical for the attainment of the desired outputs. Activities: These are actions taken, or the work performed as part of an intervention. Examples of activities include; technical advice and supervision for health workers involved in various activities, training/capacity development, coordination and review. Activities utilize inputs, such as funds, technical assistance and other types of resources to produce specific outputs. Essentially, activities or tasks are what the project will ‘do’. Outputs: These refer to all goods and services produced after implementation of activities by those involved in nutrition programs at the national and county levels in line with the priorities of KNAP and CNAPs. These will include the number of training sessions, number of those trained, number of nutrition technical supervisions at county and field levels. Programme inputs must be transformed into outputs. The quantity and quality of the outputs is very important. For instance, if one activity was the training of M&E service providers, the outputs are the number of health service providers trained. The quality of the training should also be “adequate,” so that the training results into Enhanced capacity for the delivery of M&E services. The availability of nutrition and nutrition-related policies to guide programme implementation for example, should result into Improved implementation environment at both national and county levels. Outcomes: These are changes in behaviours/practices as a result of programme activities. The outputs, if of the right quantity and quality, should produce an outcome. For example, the knowledge and skills acquired by the health service providers should enable them to take accurate anthropometric measurements of children. The desired nutrition programme outcomes are clearly stipulated in KNAP for each Key Result Area. Impacts: Refer to the achievement of higher level goals which a programme can contribute to, for example reduced malnutrition, improved financing of nutrition programmes, improved legislation for nutrition etc. Processes: These are activities carried out to achieve the programme objectives. Monitoring of these activities will show what has been done and how well and timely they have been done based on the planned nutrition programme as stipulated in the national and county level M&E Frameworks. Assumptions: Refers to the external factors, influences, situations or conditions which are necessary for programme but are largely or completely beyond the control of programme management. For example, the KNAP assumes that finances will be available for the implementation of the stipulated nutrition programmes and also for monitoring and evaluation of the programmes both at national and county levels. Accordingly, it is necessary to make assumptions explicit and list them as elements to be monitored or evaluated. Indicator : A measure of change, progress or state. Programme indicators are at various levels; input, output, process, outcome and impact. Input indicators refer to the resources needed for the implementation of an activity or intervention. Availability of policies, human resources, materials, financial resources are examples of input indicators. An input indicator will measure the extent to which the planned for inputs were actually realized or achieved. Output indicators measure the quantity and sometimes the quality of the outputs as stipulated in the work plans for example number of training sessions and the content covered in the sessions. Process indicators measure the quantity, quality and timeliness of the products (goods or services) that are the result of an activity, as stipulated in the programme work plan. Outcome indicators measure the intermediate results generated by programme outputs and correspond to any change in people’s behavior and practices as a result of project or programme activities. Impact indicators describe progress made towards higher-level goals. Examples of impact indicators derived from the KNAP include; reduced level of malnutrition and improved funding for nutrition programmes. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 17 Monitoring: Monitoring is the process of collecting data on an on-going programme/project/activity analyzing, interpreting and using it to adjust the programme so that it proceeds according to plan. Monitoring of the activities in the in the national and county M&E frameworks will be done through routine collection, collation, analyzing, interpretation and dissemination of data using standardized tools. The frequency of monitoring the activities will be undertaken monthly, quarterly and annually. Evaluation: Evaluation is the process of collecting data on on-going, completed or yet-to-start programme, analyzing and interpreting the data for purposes of determining the value of the programmes. It is the process to determine as systematically and objectively as possible, the relevance, effectiveness, efficiency and impact of programmes considering specified objectives. Evaluation typically includes measures both at the beginning, midway and at the end of a programme and when possible includes a control or comparison group to help determine whether change in outcome results is from programme activities themselves and not from other influences outside the programmes. Figure 9 illustrates the timeframe for conducting the baseline, midterm and end line reviews of the KNAP. Figure 9: KNAP evaluation timeframe MTR= Midterm Review; ETR/E= End term review/Evaluation Mid-term review A Midterm review (MTR) will be conducted to evaluate the progress made at the mid-point of implementation and recommend adjustments in strategy or review of expected targets when deemed necessary. A midterm review is also undertaken to determine the extent to which the objectives are met. Trends may be assessed together using the results of the various assessments and surveys across the different indicator domains – inputs/processes; outputs; outcomes and expected results. A mid-term review will be conducted nationally and therefore will include a representation of the counties and various stakeholders. Each County will review the implementation of the CNAP in relation to the county M&E framework and document the findings in a MTR report. The reports will be shared at the national level for overall analysis and synthesis. National and county level MTR reports will be written on the overall implementation and performance of the KNAP 2018 2022 and CNAPs respectively. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202218 End term evaluation An end-term review (ETR) will be conducted at the end of the KNAP implementation period to evaluate the overall performance of the plan and use lessons learnt to develop the subsequent interventions of the sector against what had been planned. The ETR will involve a comprehensive analysis of progress and performance for the whole period of the KNAP. The ETR will be conducted in the same manner as the MTR; it will be national with a representation of counties. Counties will conduct reviews and share their findings with the national level. County and national reports will be written on the overall implementation and performance of the CNAPs and KNAPs respectively. Accountability This is the obligation to demonstrate by stakeholders to what extent results have been achieved according to established plans and resources allocated10. Accountability will be discussed at county and national review forums and documented in the county and national reports. Learning This is the process through which information generated from M&E is reflected upon and intentionally used to continuously improve the ability of an action plan/strategy to achieve results. This learning function enhances organizational and development knowledge to increase the understanding of why particular interventions have been successful. Additionally, this understanding informs decision making and potentially improves performance. National and County level review forums for all stakeholders will be held to facilitate learning and programme changes in terms of implementation. Reporting Reporting is the systematic and timely provision of essential information used as a basis for decision-making at appropriate management levels. It is an integral part of the monitoring function. Reporting shall be done at all levels that is community, facility, sub county, county and national levels by the relevant actors on the progress of achievement of the programme implementation as stipulated in KNAP and CNAPs. These review reports will outline the performance against the targets set for the stated period. The mechanisms for providing M&E information, products, dissemination and provision of feedback to various audiences are shown in Annex 5. The annex details the what, when, where, how, and by whom of the feedback mechanisms for M&E. 10 International Federation of Red Cross and Red Crescent Societies. (2011). Project/Programmes monitoring and evaluation(M&E) guide. Geneva: IFRC. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 19 NUTRITION M&E FRAMEWORK IN KENYA CHAPTER 3 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202220 The goal of the Monitoring and Evaluation Framework is to ensure a systematic monitoring and evaluation of nutrition sector activities in Kenya in line with the Key Result Areas (KRAs) as derived from the Kenya Nutrition Action Plan 2018-2022 and serve as an accountability and learning framework for nutrition stakeholders. This chapter covers the Common Results and Accountability Framework (CRAF), Indicator matrix by Key Result Area, evaluation, learning and accountability mechanism. 3.1 Common Results Accountability Framework A set of key indicators and targets referred to as “Common Results and Accountability Framework (CRAF)” were agreed upon during the development of KNAP 2018-2022 to measure progress of achievement of the strategies outlined in the plan. The CRAF uses a logical results framework process at three levels (impacts, outcome and output). The impact targets are derived from three sources: The World Health Assembly (WHA) six targets for 2025; the global Non-Communicable Diseases (NCD) nine voluntary 2025 targets and the National Food and Nutrition Security Policy Implementation (NFNSP-IF) results matrix. Table 2: Common Results Accountability Framework: KNAP Adopted Nutrition Targets by 2022 S/N KNAP expected results (Global targets used where applicable) Indicator Baseline 2014 Target 2022 Framework for targets 1 Reduce the prevalence of stunting among children under five years by 40% Prevalence of stunting in children 0-59 months (%) 26 KDHS 2014 17 WHA target 1 NFNSP-IF 2 Reduce the prevalence of anaemia in women of reproductive age by 30% Prevalence of anaemia in women 15-49 years (%) 27 KDHS 2014 17 WHA target 2 NFNSP-IF 3 Reduce the prevalence of low birthweight by 30% Prevalence of low birth weight of 2.5 kg and below (%) 8 KDHS 2014 5 WHA target 3 4 No increase in childhood overweight/obesity Prevalence of overweight/ obesity (W/A >2SD) of children 0-59 months (%) 4 KDHS 2014 <4 WHA target 4 & NFNSP-IF 5 Increase the rate of exclusive breastfeeding in the first six months by 20% and above Prevalence of exclusive breastfeeding in children 0-6 months (%) 61 KDHS 2014 75 WHA target 5 & NFNSP-IF 6 Maintain childhood wasting at less than 4% Prevalence of wasting (W/H <2SD) in children 0-59 months (%) 4 KDHS 2014 <4 WHA target 6 & NFNSP-IF 7 Reduce childhood underweight by 30% Prevalence of underweight (W/A <2SD) in children 0-59 months 11 KDHS 2014 7 NFNSP-IF 8 Maintain proportion of deaths at below 3% for MAM and 10% for SAM Proportion (%) of discharges from treatment program who have died (among acutely malnourished children for MAM and SAM) 0.2% for MAM <0.2% MAM NFNSP-IF 1.7% for SAM DHIS 2 <1.7 SAM 9 Reduce anaemia in children 6-59 months by 30% Prevalence of anaemia in children 0-59 months (%) 26 18 KNAP 10 Reduce anaemia in pregnant women by 40% or more Prevalence of anaemia in pregnant women (%) 36 KNMS 20 NFNSP-IF 11 Reduce anaemia in adolescent girls by 30% Prevalence of anaemia in girls 15-19 years (%) 21 KNMS 15 KNAP 12 Reduce folic acid deficiency among non pregnant women by 50% Proportion of non-pregnant women with folic acid deficiency (%) 39 KNMS 20 NFNSP-IF Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 21 S/N KNAP expected results (Global targets used where applicable) Indicator Baseline 2014 Target 2022 Framework for targets 13 Reduce vitamin A deficiency in children by 50% Prevalence of VAD in children 0-59 months (%) 9 KNMS 4 NFNSP-IF 14 Reduce iodine deficiency among children <5 years by over 50% Prevalence of iodine deficiency in children <5 years (%) 22 KNMS <10 NFNSP-IF 15 Reduce iodine deficiency among non-pregnant women by over 50% Prevalence of iodine deficiency in non-pregnant women (%) 26 KNMS <10 NFNSP-IF 16 Reduce prevalence of zinc deficiency in pre school children by 40% Prevalence of zinc deficiency in children <5 years (%) 83 KNMS 50 NFNSP-IF 17 Reduce prevalence of zinc deficiency among pregnant women by 40% Prevalence of zinc deficiency among pregnant women (%) 60 KNMS 36 NFNSP-IF 18 A 10% relative reduction in prevalence of insufficient physical activity Prevalence of insufficient physical activity in adults 18–64 years of age (%) 6.5 Stepwise survey 5 NCD target 3 19 Reduce proportion of population with raised blood pressure or currently on medication by 25% Proportion of population with raised blood pressure or currently on medication (%) 24 Stepwise survey 18 NCD target 6 NFNSP-IF 20 Reduce proportion of population with raised fasting blood sugar Proportion of adults 18-69 years with raised fasting blood sugar (%) 1.9 Stepwise survey 1.5 NFNSP-IF 21 Increased proportion of men with normal waist: hip ratio Proportion of men with normal waist: hip ratio (%) 73 Stepwise survey 78 NFNSP-IF 22 Increased proportion of women with normal waist: hip ratio Proportion of women with normal waist: hip ratio (%) 64 Stepwise survey 75 NFNSP-IF 23 A 30% relative reduction in mean population intake of salt/sodium Mean intake of sodium salt (g/ day) 3 <3 NCD target 4 24 Halt and reverse the rise in obesity by 30% Prevalence of overweight/ obesity in adults (18-69 years) 28 20 NCD target 7 NFNSP-IF 25 10% of Population accessing health care services screened and assessed for nutrition status Proportion of population screened and assessed for nutrition status while accessing healthcare services No Data 10% Clinical Nutrition target 2b 26 Increase access by the population to clinical nutrition and dietetics services Proportion of population with access to clinical nutrition and dietetics services No Data 10% Clinical Nutrition target 3 27 Increased budgetary allocation towards nutrition Percentage of nutrition budget in national health budget 2% 8% Financing of nutrition 28 Increase coverage of nutrition assessment counselling and support for people living with HIV Percentage of People Living with HIV (PLHIV) in care and treatment who were nutritionally assessed < 50% NASCOP Quantification 2018 90% HIV Nutrition targets as indicated in quantification plan 29 Increase access to therapeutic and or supplemental food for clinically undernourished people living with HIV Proportion of clinically undernourished PLHIV who received therapeutic or supplementary food < 50% NASCOP Quantification 2018 90% HIV Nutrition targets as indicated in quantification plan Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202222 3.2 Indicators by Key Result Areas The tables in this section highlight the outcomes, outputs to the outcome, expected results, indicators, baseline, mid-term and end line evaluation and means of verification, frequency of verification, the lead agency responsible for verification and the associated responsible actors. Each KRA has an outcome with several outputs (expected results) and their respective indicators. For instance, KRA 1 (Maternal Neonatal Infant and Young Child Nutrition) • Outcome 1: Strengthened care practices and services for improved maternal, newborn, infant and young child nutrition • Output 1.1: Increased proportion of mothers and care givers who practice optimal behaviors for improved nutrition of women of reproductive age (15-49 years). • Indicator: Proportion of population with an acceptable household food consumption score. The KRAs are organized according to the three focus thematic areas: outcomes 1-8 are nutrition specific outcomes, outcomes 9-13 are multi-sectorial nutrition sensitive outcomes and outcome 14-19 are enabling environment outcomes. The frequency of monitoring is based on the indicator level (impact, outcome and output) and source of information. Some indicators may have more than one means of verification hence overlapping frequency and multiple sources of information. For instance, the means of verification (MOVs) for Minimum Dietary Diversity for children 6-23 months old can be in KDHS conducted every 5 years and MIYCN KABP surveys conducted every 2-3 years and therefore the frequency is indicated as 3-5 years. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 23 Ta bl e 3: K RA 1 (O ut co m e 1) In di ca to rs O u tp u t E xp ec te d R es u lt s In di ca to r B as el in e M id T er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq ue n cy Le ad A ss oc ia te d O U T CO M E 1 : K R A 1 – M A T E R N A L, N EO N AT A L IN FA N T A N D Y O U N G C H IL D N U T R IT IO N ( M N IY C N ) St re n gt h en ed ca re p ra ct ic es a n d se rv ic es fo r i m p ro ve d m at er n al , n ew b or n , i n fa n t an d y ou n g ch il d n u tr it io n O ut pu t 1. 1 In cr ea se d pr op or ti on o f m ot he rs a nd c ar e gi ve rs w ho pr ac ti ce o pt im al b eh av io rs fo r im pr ov ed n ut ri ti on o f w om en o f re pr od uc tiv e ag e (1 5 49 y ea rs ) Pr op or ti on o f p op ul at io n w it h an ac ce pt ab le h ou se ho ld fo od c on su m pt io n sc or e (F CS ). 8 8 .8 % (K D H S 20 14 ) 9 2 % 9 5 % (K D H S 20 14 ) K D H S R ep or t N ut ri ti on SM A RT S ur ve ys 3 5 ye ar s M O H Pa rt ne rs K N B S O ut pu t 1. 2 In cr ea se d pr op or ti on o f c ar e gi ve rs w ho p ra ct ic e op ti m al b eh av io rs fo r im pr ov ed n ut ri ti on o f y ou ng ch ild re n un de r fiv e ye ar s Pe rc en ta ge o f c hi ld re n bo rn in th e la st 2 4 m on th s w ho w er e pu t t o th e br ea st w it hi n on e ho ur o f b ir th 6 2 % (K D H S 20 14 ) 6 8 % 7 0 % (K D H S 20 14 ) K D H S R ep or t M IY CN K A B P su rv ey s 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f i nf an ts 0 –5 m on th s of a ge w ho a re fe d ex cl us iv el y w it h br ea st m ilk 6 1 .4 % (K D H S 20 14 ) 6 8 % 7 5 % (K D H S 20 14 ) K D H S R ep or t M IY CN K A B P su rv ey s 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f c hi ld re n 1 8– 23 m on th s of ag e w ho a re fe d br ea st m ilk 5 3 % (K D H S 20 14 ) 5 7 % 60 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f i nf an ts 6 –8 m on th s of a ge w ho r ec ei ve so lid , s em i so lid o r so ft fo od s. 8 0 % (K D H S 20 14 ) 8 3 % 85 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f c hi ld re n 6– 23 m on th s of a ge w ho r ec ei ve fo od s fr om 4 o r m or e fo od gr ou ps . 4 1 % (K D H S 20 14 ) 4 9 % 55 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f b re as tf ed a nd n on b re as tf ed ch ild re n 6– 23 m on th s of a ge w ho r ec ei ve so lid , s em i so lid , o r so ft fo od s (b ut a ls o in cl ud in g m ilk fe ed s fo r no n br ea st fe d ch ild re n) th e m in im um n um be r of ti m es o r m or e. 51 % (K D H S 20 14 ) 59 % 65 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f c hi ld re n 6– 23 m on th s of a ge w ho r ec ei ve a m in im um a cc ep ta bl e di et (W H O 2 01 0 de fin it io n) 21 % 25 % 30 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202224 O u tp u t E xp ec te d R es u lt s In di ca to r B as el in e M id T er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq ue n cy Le ad A ss oc ia te d Pr op or ti on o f c hi ld re n 6– 23 m on th s of ag e w ho r ec ei ve a n ir on r ic h fo od o r ir on fo rt ifi ed fo od th at is s pe ci al ly d es ig ne d fo r in fa nt s an d yo un g ch ild re n, o r th at is fo rt ifi ed in th e ho m e. 33 .3 % (K D H S 20 14 ) 36 % 40 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S Pr op or ti on o f c hi ld re n 0– 23 m on th s of a ge w ho a re fe d w it h a bo tt le . 22 % (K D H S 20 14 ) 17 % 15 % (K D H S 20 14 ) K D H S R ep or t 3 5 ye ar s M O H Pa rt ne rs K N B S N o of H um an M ilk B an ks E st ab lis he d 1 2 3 D N D R ep or t A nn ua lly D N D Pa rt ne rs K N B S O ut pu t 1. 3. M IY CN a dv oc at ed fo r at g lo ba l, na ti on al a nd c ou nt y le ve ls Pr op or ti on o f c ou nt ie s w it h in it ia tiv es fo r w or kp la ce s up po rt fo r br ea st fe ed in g at pu bl ic a nd p ri va te w or k pl ac es N o D at a 25 % 50 % D N D R ep or t A nn ua lly D N D Co un ty O ut pu t 1. 4 En ha nc ed c ap ac it y fo r im pl em en ta ti on o f M IY CN ac tiv it ie s at a ll le ve ls N o. o f n at io na l n ut ri ti on c on fe re nc es / sy m po si um h el d 0 3 5 D N D R ep or t A nn ua lly D N D Pa rt ne rs a nd st ak eh ol de rs O ut pu t 1. 5. Im pr ov ed M IY CN p ol ic y en vi ro nm en t a t n at io na l a nd co un ty le ve l N o. o f M IY CN p ol ic ie s/ s tr at eg ie s re vi ew ed 0 2 4 D N D R ep or t D N D 3 ye ar s Pa rt ne rs a nd nu tr it io n st ak eh ol de rs Ta bl e 4: K RA 2 (O ut co m e 2) In di ca to rs O u tp u t E xp ec te d R es u lt s In di ca to r B as el in e M id T er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq ue n cy Le ad A ss oc ia te d K R A 2 : N U T R IT IO N O F O LD ER C H IL D R EN A N D A D O LE SC EN T S In cr ea se d n ut ri ti on a w ar en es s an d up ta ke o f n ut ri ti on s er vi ce s fo r im pr ov ed n ut ri ti on s ta tu s of o ld er c hi ld re n ( 5 9 ye ar s) a n d ad ol es ce n ts ( 10 1 9 ye ar s) O ut pu t 2. 1 In cr ea se d aw ar en es s on h ea lt hy di et s am on g ca re gi ve rs , s oc ia l in flu en ce rs , o ld er c hi ld re n an d ad ol es ce nt s th em se lv es . N o. o f t ra in in gs o f k ey s ta ke ho ld er s on nu tr it io n fo r ol de r ch ild re n 3 (D N D 20 17 ) 7 10 Tr ai ni ng re po rt s A nn ua lly D N D Pa rt ne rs O ut pu t 2. 2 R ed uc ti on o f m ar ke ti ng o f un he al th y fo od s am on g ol de r ch ild re n an d ad ol es ce nt s Pr op or ti on o f t hi n ad ol es ce nt s (f al lin g be lo w c ut of f f or B M I fo r a ge ) N o B as el in e D at a 40 % 30 % (S TE PS ) K D H S/ St ep w is e su rv ey R ep or t 5 ye ar s D N D Pa rt ne rs Pr op or ti on o f a do le sc en ts fa lli ng b el ow cu t of f f or h ei gh t fo r ag e (S tu nt in g) N o B as el in e D at a 50 % 40 % (S TE PS ) K D H S/ St ep w is e su rv ey R ep or t 5 ye ar s D N D Pa rt ne rs Pr op or ti on o f o be se a do le sc en ts ( fa lli ng ab ov e cu t o ff fo r B M I fo r ag e) N o ba se lin e D at a 30 % 15 % (S TE PS ) K D H S/ St ep w is e su rv ey R ep or t 5 ye ar s D N D Pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 25 O u tp u t E xp ec te d R es u lt s In di ca to r B as el in e M id T er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq ue n cy Le ad A ss oc ia te d O ut pu t 2. 3: En ha nc ed li nk ag es a nd co lla bo ra ti on w it h re le va nt se ct or s to p ro m ot e th e he al th a nd nu tr it io n of th e ol de r ch ild a nd ad ol es ce nt N o of c ol la bo ra ti on s w it h re le va nt s ec to rs on n ut ri ti on fo r ol de r ch ild re n an d ad ol es ce nt s N o ba se lin e da ta 7 10 M in ut es o n co lla bo ra ti on m ee ti ng s A nn ua lly D N D Pa rt ne rs Ta bl e 5: K RA 3 (O ut co m e 3) In di ca to rs O u tp u t E xp ec te d R es u lt s In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O U T CO M E 3 : K R A 3 – A D U LT S A N D O L D E R P E R SO N S Im p ro ve d n u tr it io n s ta tu s of a d u lt s an d o ld er p er so n s O ut pu t 3. 1 Pr om ot io n of n ut ri ti on s up po rt fo r ol de r pe rs on s Pr op or ti on o f c ou nt ie s w it h st ra te gi es on m an ag em en t o f n ut ri ti on o f t he o ld er pe rs on s in th ei r CN A P 0 (D N D 20 18 ) 32 pe rc en t 64 p er ce nt Co un ty C N A P A nn ua lly Co un ty Pa rt ne rs O ut pu t 3. 2 St re ng th en ed fo od an d nu tr it io n se cu ri ty s ys te m s fo r ol de r pe rs on s. N o. o f m ap pi ng s ur ve ys o n fo od a nd nu tr it io n se cu ri ty c on du ct ed 0 (D N D 20 18 ) 0 1 M ap pi ng R ep or t Q ua rt er ly / A nn ua lly M O H Pa rt ne rs O ut pu t 3. 3 A dv oc ac y, c om m un ic at io n an d so ci al m ob ili za ti on o f n ut ri ti on o f ol de r pe rs on s st re ng th en ed a nd pr om ot ed Pr op or ti on o f p op ul at io n aw ar e of g er ia tr ic nu tr iti on N o da ta (2 01 8) 1 0 % 4 0 % (M O H 20 18 ) K A P su rv ey 3 ye ar s M O H Pa rt ne rs St re ng th en ed fi na nc in g an d hu m an r es ou rc e ca pa ci ty m ec ha ni sm s fo r nu tr it io n in te rv en ti on s fo r ol de r pe rs on s Pr op or ti on o f n ut ri ti on b ud ge t a llo ca te d to th e ol de r pe rs on s 0 (M O H 20 18 ) 2 % 2 % (M O H 20 18 ) B ud ge t it em iz at io n A nn ua lly M O H Pa rt ne rs N o. o f c ou nt ie s in cl ud in g ol de r pe rs on s, in th ei r bu dg et ar y de ve lo pm en t p ro ce ss 0 (M O H 20 18 ) 2 0 % 4 8 % (M O H 20 18 ) Pa rt ic ip an t l is ts A nn ua lly Co un ty Pa rt ne rs Ta bl e 4: K RA 2 (O ut co m e 2) In di ca to rs O u tp u t E xp ec te d R es u lt s In di ca to r B as el in e M id T er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq ue n cy Le ad A ss oc ia te d K R A 2 : N U T R IT IO N O F O LD ER C H IL D R EN A N D A D O LE SC EN T S In cr ea se d n ut ri ti on a w ar en es s an d up ta ke o f n ut ri ti on s er vi ce s fo r im pr ov ed n ut ri ti on s ta tu s of o ld er c hi ld re n ( 5 9 ye ar s) a n d ad ol es ce n ts ( 10 1 9 ye ar s) O ut pu t 2. 1 In cr ea se d aw ar en es s on h ea lt hy di et s am on g ca re gi ve rs , s oc ia l in flu en ce rs , o ld er c hi ld re n an d ad ol es ce nt s th em se lv es . N o. o f t ra in in gs o f k ey s ta ke ho ld er s on nu tr it io n fo r ol de r ch ild re n 3 (D N D 20 17 ) 7 10 Tr ai ni ng re po rt s A nn ua lly D N D Pa rt ne rs O ut pu t 2. 2 R ed uc ti on o f m ar ke ti ng o f un he al th y fo od s am on g ol de r ch ild re n an d ad ol es ce nt s Pr op or ti on o f t hi n ad ol es ce nt s (f al lin g be lo w c ut of f f or B M I fo r a ge ) N o B as el in e D at a 40 % 30 % (S TE PS ) K D H S/ St ep w is e su rv ey R ep or t 5 ye ar s D N D Pa rt ne rs Pr op or ti on o f a do le sc en ts fa lli ng b el ow cu t of f f or h ei gh t fo r ag e (S tu nt in g) N o B as el in e D at a 50 % 40 % (S TE PS ) K D H S/ St ep w is e su rv ey R ep or t 5 ye ar s D N D Pa rt ne rs Pr op or ti on o f o be se a do le sc en ts ( fa lli ng ab ov e cu t o ff fo r B M I fo r ag e) N o ba se lin e D at a 30 % 15 % (S TE PS ) K D H S/ St ep w is e su rv ey R ep or t 5 ye ar s D N D Pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202226 Ta bl e 6: K RA 4 (O ut co m e 4) In di ca to rs O U T CO M E 4 : K R A 4 M IC R O N U T R IE N T S Im pr ov ed m ic ro n ut ri en t s ta tu s of C hi ld re n , a do le sc en ts , w om en o f r ep ro du ct iv e ag e, m en a n d ol de r pe rs on s O u tp u t E xp ec te d R es u lt s In d ic at or B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 4. 1 St re ng th en ed r ou ti ne m ic ro nu tr ie nt s up pl em en ta ti on (v it am in A , i ro n an d fo la te , a nd po in t o f u se fo rt ifi ca tio n) fo r ta rg et ed g ro up s Pr op or ti on o f c hi ld re n ag ed 6 5 9 m on th s re ce iv in g V it am in A s up pl em en ts a t l ea st tw o do se s an nu al ly . 4 6 % (K H IS 20 17 ) 5 6 % 6 5 % (K H IS 20 17 ) D H IS R ep or t B i an n u al ly / an n u al ly M O H U N IC EF , N I, M ap In ti l, K R CS , Pr op or ti on o f p re gn an t w om en w ho ta ke Ir on a nd F ol at e Su pp le m en ts fo r at le as t 9 0 da ys 8 % (K H IS 20 17 ) 1 5 % (K H IS 20 17 ) 4 0 % (K H IS 20 17 ) D H IS R ep or t M o n th ly M O H N I, U N IC EF , W V K , K R CS , Sa ve th e Ch ild re n, W FP Pe rc en ta ge o f c hi ld re n ag ed 6 2 3 m on th s pr ov id ed w it h m ul ti pl e m ic ro nu tr ie nt po w de rs N o da ta (2 01 8) 1 0 % 2 5 % (K H IS 20 17 ) D H IS R ep or t M o n th ly M O H N I, U N IC EF , W FP , W V K , G A IN O ut pu t 4. 2 In cr ea se d di et ar y di ve rs it y an d bi o fo rt ifi ca tio n of fo od p la nt s Pr op or ti on o f t he p op ul at io n ac ce ss in g ad eq ua te m ic ro n ut ri en t i nt ak e N o da ta (2 01 8) > 1 5 % > 2 5 % H ou se ho ld Fo od co ns um pt io n Su rv ey , K IH B S, A nn ua l f oo d pr od uc ti on re po rt s, A nn ua l f oo d as se ss m en t re po rt s. Q u ar te rl y/ A n n u al ly M o A & M o H FA O , K E M R I O ut pu t 4. 3 Im pr ov ed c om pl ia nc e to fo od fo rt ifi ca tio n st an da rd s Pr op or ti on o f a de qu at el y fo rt ifi ed fo od s in th e m ar ke t ( m ai ze a nd w he at fl ou r, sa lt , fa ts /o ils ) N o da ta (2 01 8) 6 0 % 8 0 % Pe ri od ic su rv ey s A n n u al ly M O H K E B S, N PH L, Is tr ie s O ut pu t 4. 4 In cr ea se d kn ow le dg e, im pr ov ed pr ac ti ce s an d co ve ra ge o f f or ti fie d fo od s Pr op or ti on o f h ou se ho ld s co ns um in g fo rt ifi ed fo od s (m ai ze a nd w he at fl ou r, sa lt , fa ts /o ils ) N o D at a (2 01 8) 5 0 % 7 0 % Su rv ey R ep or ts ; K D H S; K IH B S 3 y ea rs M O H K E B S, N PH L, Is tr ie s O ut pu t 4. 5 In te gr at ed p ub lic h ea lt h m ea su re s w it h ot he r m ic ro nu tr ie nt de fic ie nc ie s pr ev en ti on a nd co nt ro l i nt er ve nt io ns . Pr op or ti on o f p ub lic h ea lth in te rv en ti on s in te gr at in g M ic ro nu tr ie nt s de fic ie nc y an d co nt ro l m ea su re s. N o da ta (2 01 8) 2 4 Pr og ra m m es re po rt s, A nn ua l W or k Pl an r ep or ts . A n n u al ly M O H M O E Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 27 Ta bl e 7: K RA 5 (O ut co m e 5) In di ca to rs O U T CO M E 5 : K R A 5 – D R N C D S (D ie t re la te d N on c om m u n ic ab le d is ea se s. R ed u ce d p re va le n ce o f d ie t r el at ed r is k fa ct or s fo r N C D s in g en er al p op u la ti on Im p ro ve d m an ag em en t a n d co n tr ol o f t h e n on c om m u n ic ab le d is ea se s t h ro u gh n u tr it io n t h er ap y O u tp u t E xp ec te d R es u lt s In d ic at or B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 5. 1 R ai se d pr io ri ty a cc or de d to N ut ri ti on in N CD s at n at io na l a nd co un ty le ve ls an d to in te gr at e th ei r pr ev en ti on an d co nt ro l i nt o po lic ie s ac ro ss a ll go ve rn m en t a nd p ri va te s ec to rs . N um be r of N CD I CC m ee ti ng w it h re pr es en ta ti on fr om N IT W G N o da ta (2 01 8) 2 4 IC C m ee ti ng s m in ut es Q ua rt er ly / A nn ua lly M O H N C D D N D Ci vi l S oc ie ty O rg an iz at io ns Co G Pr op or ti on o f c ou nt ie s w it h bu dg et s fo r N CD s 1 0 % 1 5 % 3 0 % Co un ti es A W Ps an d in ve st m en t pl an s Co un ty R ep or ts A nn ua lly C O G Tr ea su ry Pr op or ti on o f N at io na l h ea lt h bu dg et al lo ca te d to N CD s N o da ta (2 01 8) 1 % 5 % M in is te ri al AW Ps a nd in ve st m en t pl an s A nn ua lly M O H N C D Tr ea su ry O ut pu t 5. 2 St re ng th en ed n at io na l a nd c ou nt y ca pa ci ty , l ea de rs hi p, g ov er na nc e an d pa rt ne rs hi ps to a cc el er at e co un tr y re sp on se fo r pr ev en ti on of N CD s N um be r of p ol ic y m ak er s an d he al th ca re w or ke rs tr ai ne d on N ut ri ti on N CD pr ev en ti on a nd m an ag em en t 10 0 20 0 50 0 Tr ai ni ng at te nd an ce li st Tr ai ni ng re po rt s Q ua rt er ly / an nu al ly D N C D D N D Co un ty G ov er nm en ts O ut pu t 5. 3 In cr ea se v is ib ili ty o f N CD s w it hi n pu bl ic & p ri va te m ed ia h ou se s Pr op or ti on o f p ub lic & p ri va te m ed ia ho us es s en si ti ze d on n ut ri ti on a nd N CD s N o da ta (2 01 8) 8 % 2 5 % M in ut es , A tt en da nc e lis t, re po rt s A nn ua lly D N C D D N D Pa rt ne rs C iv il So ci et y O ut pu t 5. 4 Pr ev en ti on a nd c on tr ol o f N CD s in te gr at ed in to p ol ic ie s ac ro ss r el ev an t g ov er nm en t se ct or s. N um be r of N CD s pr ev en ti on a nd c on tr ol po lic ie s in s ec to rs o ut si de h ea lt h (A gr ic ul tu re , Tr ad e, E du ca ti on , L ab or , I nf ra st ru ct ur e, Fi na nc e, P la nn in g an d En vi ro nm en t N o da ta (2 01 8) 4 8 Po lic ie s ex is ti ng a nd de ve lo pe d A nn ua lly M in is tr y of A gr ic ul tu re , T ra de , Ed uc at io n, La bo ur , I n fr as tr uc tu re , Pl an ni ng , En vi ro nm en t Pa rt ne rs C iv il So ci et y D N CD H O ut pu t 5. 5 H ea lt hy d ie ts a nd li fe st yl es pr om ot ed to r ed uc e th e m od ifi ab le r is k fa ct or s fo r N CD s Pr op or ti on o f p op ul at io n re ad in g nu tr ie nt co nt en t i n fo od p ro du ct s N o da ta (2 01 8) 10 % 30 % A ct s of pa rl ia m en t, ho us eh ol d su rv ey r ep or ts 2 ye ar s D N CD D N D Ci vi l S oc ie ty Pa rt ne rs O ut pu t 5. 6 Q ua lit y an d ti m el y tr ea tm en t f or N CD s is p ro vi de d Pr op or ti on o f p ub lic h os pi ta ls w it h N CD an d nu tr it io n m an ag em en t c en te rs 10 % 30 % 65 % M & E R ep or ts D H IS r ep or ts M on th ly / qu ar te rl y M O H D N CD K N B S O ut pu t 5. 7 Im pr ov ed m on it or in g an d ev al ua ti on fo r di et r el at ed N CD s N um be r of N CD in di ca to rs c ap tu re d in D H IS a nd o th er d at a re po rt in g pl at fo rm s 4 12 20 Q ua rt er ly an d an nu al re po rt s in D H IS a nd o th er pl at fo rm s Q ua rt er ly / an nu al ly M O H D N CD , H IS H Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202228 Ta bl e 8: K RA 6 (O ut co m e 6) In di ca to rs O U T CO M E 6 : K R A 6 – ( In te gr at ed M an ag em en t of A cu te M al n u tr it io n ) IM A M In cr ea se d c ov er ag e of in te gr at ed M an ag em en t of A cu te M al n u tr it io n (I M A M ) O u tp u t E xp ec te d R es u lt s In d ic at or B as el in e M id te rm E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 6. 1 IM A M s er vi ce s ac ro ss a ll co ho rt s re vi ew ed a nd s ca le u p N o. o f h ea lt h fa ci lit ie s w it h ca pa ci ty fo r IM A M S er vi ce d el iv er y 18 73 21 00 25 00 K H IS M o n th ly D N D Co G Pr op or ti on o f c hi ld re n w it h ac ut e m al nu tr it io n ac ce ss in g IM A M se rv ic es N o B as el in e D at a 7 5 % 8 5 % (K H IS ) K H IS (M O H 7 1 3 ) Se as on al A ss es sm en t R ep or ts M o n th ly D N D Co G N o. o f h ea lt h fa ci lit ie s im pl em en ti ng IM A M s er vi ce s 18 73 21 00 25 00 K H IS M o n th ly D N D Co G O ut pu t 6. 2 Q ua lit y of IM A M s er vi ce s im pr ov ed N um be r of c ou nt ie s m ee ti ng s ph er e st an da rd s fo r IM A M N o B as el in e D at a 20 47 K H IS M o n th ly D N D Co G Ta bl e 9: K RA 7 (O ut co m e 7) In di ca to rs O U T CO M E 7 : K R A 7 E M E R G E N C IE S Im pr ov ed m ul ti l ev el , a n d m ul ti s ec to ra l c ap ac it y fo r ri sk p re pa re dn es s, r ed uc ti on a n d m it ig at io n ag ai n st im pa ct o f d is as te rs O u tp u t Ex pe ct ed R es ul ts In di ca to r B as el in e M id te rm E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 7. 1 Fu nc ti on al C oo rd in at io n co m m it te es in p la ce a nd in te gr at in g pr ep ar ed ne ss a nd ri sk r ed uc ti on a ge nd a / ac ti on s Fu nc ti on al n at io na l e m er ge nc y pr ep ar ed ne ss c oo rd in at io n st ru ct ur es N o Ye s Ye s M ee ti ng m in ut es Q ua rt er ly D N D Co un ty O ut pu t 7. 2 N ut ri ti on s ec to r re pr es en ta ti on in m ul ti s ec to ra l c oo rd in at io n fo ru m s fo r pr ep ar ed ne ss a nd ri sk r ed uc ti on Pr op or ti on o f m ul ti s ec to ra l co or di na ti on fo ru m s fo r em er ge nc y pr ep ar ed ne ss w it h nu tr it io n se ct or re pr es en ta tio n an nu al ly N o B as el in e D at a 8 0 % 1 0 0 % M ee ti ng m in ut es Q ua rt er ly D N D Co un ty Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 29 O U T CO M E 7 : K R A 7 E M E R G E N C IE S Im pr ov ed m ul ti l ev el , a n d m ul ti s ec to ra l c ap ac it y fo r ri sk p re pa re dn es s, r ed uc ti on a n d m it ig at io n ag ai n st im pa ct o f d is as te rs O ut pu t 7. 3 N ut ri tio n in te gr at ed in D is as te r pr ep ar ed ne ss a nd r es po ns e pl an a t C ou nt y le ve l N um be r of c ou nt ie s im pl em en ti ng IM A M s ur ge 8 12 15 IM A M s u rg e re p or ts M on th ly D N D Co un ty N um be r of c ou nt ie s w it h in te gr at ed co nt in ge nc y, p re pa re dn es s an d re sp on se p la ns 23 47 47 U pd at ed Co un ty co nt in ge nc y, pr ep ar ed ne ss an d re sp on se pl an s B i a nn ua lly . D N D Co un ty O ut pu t 7. 4 En ha nc ed N ut ri ti on s ec to r pa rt ic ip at io n in e ar ly w ar ni ng sy st em r ev ie w p ro ce ss es Pr op or ti on o f r ev ie w m ee ti ng s on e ar ly w ar ni ng s ys te m w it h N ut ri ti on S ec to r pr es en ce 5 0 % 8 0 % 1 0 0 % R ev ie w m ee ti ng re po rt a nd m in ut es Q ua rt er ly D N D Co un ty O ut pu t 7. 5 Im pr ov ed n ut ri ti on n ee ds as se ss m en ts d ur in g em er ge nc ie s Pr op or ti on o f e m er ge nc y re sp on se s in cl ud in g nu tr it io n ne ed s as se ss m en ts d ur in g em er ge nc ie s N o da ta (2 01 8) 7 5 % 8 0 % A ss es sm en ts R ep or ts A nn ua lly D N D Co un ty O ut pu t 7. 6 In cr ea se d ac ce ss to H ig h im pa ct N ut ri tio n in te rv en ti on s as pa rt o f e m er ge nc y re sp on se (M IY C N E , I M A M , M ic ro nu tr ie nt su pp le m en ta ti on , D ew or m in g, W A SH in te rv en ti on s) Pr op or ti on o f e m er ge nc y re sp on se s in te gr at in g co m pr eh en si ve H ig h Im pa ct N ut ri ti on in te rv en ti on s (I M A M , M ic ro nu tr ie nt s up pl em en ta ti on , D ew or m in g, W A SH in te rv en ti on s) du ri ng e m er ge nc ie s N o B as el in e D at a 7 5 % 8 5 % R ou ti ne Pr og ra m m es re po rt s M o n th ly D N D Co un ty Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202230 Ta bl e 11 : K RA 9 (O ut co m e 9) In di ca to rs O U T CO M E 9 : K R A 9 – C L IN IC A L N U T R IT IO N A N D D IE T E T IC S Im pr ov ed a n d sc al ed u p pr ac ti ce s re la te d to c li n ic al n ut ri ti on a n d di et et ic s fo r di se as e pr ev en ti on , c on tr ol a n d m an ag em en t O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 9. 1 N ut ri tio n sc re en in g, a ss es sm en t an d tr ia ge to a ll in di vi du al s se ek in g he al th c ar e pr om ot ed Pr op or ti on o f p op ul at io n ac ce ss in g he al th c ar e se rv ic es a t t he fa ci lit ie s sc re en ed a nd a ss es se d fo r nu tr it io n st at us N o ba se lin e da ta 1 0 % 2 0 % K H IS M on th ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 2 En ha nc ed n ut ri ti on s cr ee ni ng a nd as se ss m en t a t f ac ili ty le ve l Pr op or ti on o f h ea lt h fa ci lit ie s im pl em en ti ng th e na ti on al S O Ps o n nu tr it io n sc re en in g, a ss es sm en t a nd tr ia ge N o ba se lin e da ta 4 0 % 6 0 % K H IS M o n th ly M oH , D N D Co un ty G ov er nm en ts Pr op or ti on o f h ea lt h fa ci lit ie s eq ui pp ed w it h nu tr it io n sc re en in g an d as se ss m en t eq ui pm en t N o ba se lin e da ta 5 0 % 6 5 % Co un ty re po rt s Fa ci lit y as se ss m en t re po rt s Q ua rt er ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 3 St re ng th en ed In te r fa ci lit y re fe rr al s ys te m fo r nu tr it io n se rv ic es N o. o f c ou nt ie s se ns it iz ed o n th e us e of st an da rd in te r fa ci lit y nu tr it io n re fe rr al to ol N o ba se lin e da ta 25 47 Pr og ra m R ep or ts Q ua rt er ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 4 Im pr ov ed q ua lit y o f c ar e i n th e nu tr it io n m an ag em en t o f d is ea se s, co m or bi di ti es a nd c on di ti on s N o. o f c ou nt ie s se ns it iz ed o n th e us e of na ti on al b as ic e ss en ti al n ut ri ti on c ar e pa ck ag e in m an ag em en t o f d is ea se s, c o m or bi di ti es a nd c on di ti on s N o ba se lin e da ta 25 47 Pr og ra m R ep or ts M on th ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 5 St re ng th en ed m an ag em en t o f m al nu tr it io n in d is ea se a nd il ln es s Pr op or ti on o f h os pi ta ls w it h di se as e sp ec ifi c th er ap eu ti c fe ed s an d su pp le m en ts fo r m an ag em en t o f m al nu tr it io n in il ln es s an d di se as e N o ba se lin e da ta 5 0 % 6 5 % Co un ty re po rt s Fa ci lit y as se ss m en t re po rt s M oH , D N D D N D Q u ar te rl y Co un ty G ov er nm en ts O ut pu t 9. 6 Cl in ic al n ut ri ti on a nd d is ea se m an ag em en t i n th e co m m un it y Pr op or ti on o f c ou nt ie s se ns it iz ed o n co nt in uu m o f n ut ri ti on c ar e in th e co m m un it y N o ba se lin e 2 0 % 4 0 % Tr ai ni ng R ep or t A tt en da nc e sh ee ts M oH , D N D D N D Q ua rt er ly Co un ty G ov er nm en ts O ut pu t 9. 7 Im pr ov ed p at ie nt fe ed in g in he al th ca re in st it ut io ns Pr op or ti on o f h os pi ta ls o ffe ri ng in pa ti en t fe ed in g w it h st an da rd th er ap eu ti c fo od pr od uc ti on u ni ts N o ba se lin e 5 % 1 0 % Co un ty R ep or ts Fa ci lit y as se ss m en t re po rt s M oH , D N D D N D Q u ar te rl y Co un ty G ov er nm en ts N o. o f c ou nt ie s se ns it iz ed o n th e us e of m on it or in g to ol fo r in pa ti en t f ee di ng N o ba se lin e 10 35 Tr ai ni ng R ep or t A tt en da nc e sh ee ts M oH , D N D D N D Q u ar te rl y Co un ty G ov er nm en ts O ut pu t 9. 8 St re ng th en ed te ch ni ca l c ap ac it y fo r cl in ic al n ut ri tio n an d di et et ic s Pr op or ti on o f h ea lt h ca re w or ke rs tr ai ne d on c lin ic al n ut ri ti on p ac ka ge N o ba se lin e 2 0 % 4 0 % Co un ty R ep or t M oH , D N D D N D A n n u al ly Co un ty G ov er nm en ts Ta bl e 10 : K RA 8 (O ut co m e 8) In di ca to rs O U T CO M E 8 : K R A 8 – N U T R IT IO N I N H IV A N D T B R ed u ce d im p ac t o f H IV r el at ed c o m or b id it ie s am on g P eo p le L iv in g w it h H IV th ro u gh ta rg et ed n u tr it io n th er ap y O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id te rm E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 8. 1 Im pr ov ed r ou ti ne s cr ee ni ng fo r nu tr it io n pr ob le m s an d re fe rr al fo r al l T B a nd H IV p at ie nt s Pr op or ti on o f p at ie nt s sc re en ed a nd re fe rr ed fo r nu tr it io n pr ob le m s 60 .1 % 75 % 95 % K H IS Q u ar te rl y M O H – N A SC O P N ut ri ti on Co un ty , Pa rt ne rs O ut pu t 8. 2 In cr ea se d co ve ra ge fo r nu tr it io n in te gr at io n fo r sc re en in g an d re fe rr al o f P LH IV a nd T B P at ie nt s in n ut ri ti on c lin ic s N o of fa ci lit ie s c on du ct in g nu tr it io n sc re en in g fo r H IV a nd T B in n ut ri ti on cl in ic s fo r id en ti fic at io n 12 .7 % 15 % 30 % A nn ua l r ep or ts , Co un ty r ep or ts A nn ua lly M O H N A SC O P Co un ti es G ov er nm en ts , Pa rt ne rs Pr op or ti on o f h ea lt h fa ci lit ie s eq ui pp ed w it h nu tr it io n sc re en in g an d as se ss m en t eq ui pm en t N o ba se lin e da ta 5 0 % 6 5 % B ia nn ua l Co m m od it y su pp or t su pe rv is or re po rt s Co un ty r ep or ts Fa ci lit y as se ss m en t re po rt s Q u ar te rl y M oH , N A SC O P N ut ri ti on Co un ty G ov er nm en ts O ut pu t 8. 3 St re ng th en ed in te gr at io n of nu tr it io n in te rv en ti on s fo r ho m e ba se d ca re a t c om m un it y l ev el fo r PL H IV s to w ar ds th e 90 .9 0. 90 Pr op or ti on o f h ea lt h fa ci lit ie s un de rt ak in g nu tr it io n in te gr at io n ac tiv it ie s 1 2 .7 % 3 0 % 5 0 % Pr og ra m m es re po rt s M o n th ly M O H N A SC O P N ut ri ti on Co un ti es Pa rt ne rs O ut pu t 8. 4 En ha nc ed u se o f i m pl em en ta ti on re se ar ch to g en er at e ev id en ce fo r co st e ffe ct iv e nu tr it io n TB a nd H IV pr og ra m m in g Pr op or ti on o f i n co un tr y re se ar ch r es ul ts in u se in th e co un tr y in H IV n ut ri ti on pr og ra m m in g O ne re se ar ch re po rt ev er y 2 ye ar s O ne re se ar ch re po rt ev er y 2 ye ar s In c ou nt ry St ud y re po rt s av ai la bl e an d in us e 2 y ea rs M O H N A SC O P N u tr it io n Co un ty Pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 31 Ta bl e 11 : K RA 9 (O ut co m e 9) In di ca to rs O U T CO M E 9 : K R A 9 – C L IN IC A L N U T R IT IO N A N D D IE T E T IC S Im pr ov ed a n d sc al ed u p pr ac ti ce s re la te d to c li n ic al n ut ri ti on a n d di et et ic s fo r di se as e pr ev en ti on , c on tr ol a n d m an ag em en t O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 9. 1 N ut ri tio n sc re en in g, a ss es sm en t an d tr ia ge to a ll in di vi du al s se ek in g he al th c ar e pr om ot ed Pr op or ti on o f p op ul at io n ac ce ss in g he al th c ar e se rv ic es a t t he fa ci lit ie s sc re en ed a nd a ss es se d fo r nu tr it io n st at us N o ba se lin e da ta 1 0 % 2 0 % K H IS M on th ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 2 En ha nc ed n ut ri ti on s cr ee ni ng a nd as se ss m en t a t f ac ili ty le ve l Pr op or ti on o f h ea lt h fa ci lit ie s im pl em en ti ng th e na ti on al S O Ps o n nu tr it io n sc re en in g, a ss es sm en t a nd tr ia ge N o ba se lin e da ta 4 0 % 6 0 % K H IS M o n th ly M oH , D N D Co un ty G ov er nm en ts Pr op or ti on o f h ea lt h fa ci lit ie s eq ui pp ed w it h nu tr it io n sc re en in g an d as se ss m en t eq ui pm en t N o ba se lin e da ta 5 0 % 6 5 % Co un ty re po rt s Fa ci lit y as se ss m en t re po rt s Q ua rt er ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 3 St re ng th en ed In te r fa ci lit y re fe rr al s ys te m fo r nu tr it io n se rv ic es N o. o f c ou nt ie s se ns it iz ed o n th e us e of st an da rd in te r fa ci lit y nu tr it io n re fe rr al to ol N o ba se lin e da ta 25 47 Pr og ra m R ep or ts Q ua rt er ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 4 Im pr ov ed q ua lit y o f c ar e i n th e nu tr it io n m an ag em en t o f d is ea se s, co m or bi di ti es a nd c on di ti on s N o. o f c ou nt ie s se ns it iz ed o n th e us e of na ti on al b as ic e ss en ti al n ut ri ti on c ar e pa ck ag e in m an ag em en t o f d is ea se s, c o m or bi di ti es a nd c on di ti on s N o ba se lin e da ta 25 47 Pr og ra m R ep or ts M on th ly M oH , D N D Co un ty G ov er nm en ts O ut pu t 9. 5 St re ng th en ed m an ag em en t o f m al nu tr it io n in d is ea se a nd il ln es s Pr op or ti on o f h os pi ta ls w it h di se as e sp ec ifi c th er ap eu ti c fe ed s an d su pp le m en ts fo r m an ag em en t o f m al nu tr it io n in il ln es s an d di se as e N o ba se lin e da ta 5 0 % 6 5 % Co un ty re po rt s Fa ci lit y as se ss m en t re po rt s M oH , D N D D N D Q u ar te rl y Co un ty G ov er nm en ts O ut pu t 9. 6 Cl in ic al n ut ri ti on a nd d is ea se m an ag em en t i n th e co m m un it y Pr op or ti on o f c ou nt ie s se ns it iz ed o n co nt in uu m o f n ut ri ti on c ar e in th e co m m un it y N o ba se lin e 2 0 % 4 0 % Tr ai ni ng R ep or t A tt en da nc e sh ee ts M oH , D N D D N D Q ua rt er ly Co un ty G ov er nm en ts O ut pu t 9. 7 Im pr ov ed p at ie nt fe ed in g in he al th ca re in st it ut io ns Pr op or ti on o f h os pi ta ls o ffe ri ng in pa ti en t fe ed in g w it h st an da rd th er ap eu ti c fo od pr od uc ti on u ni ts N o ba se lin e 5 % 1 0 % Co un ty R ep or ts Fa ci lit y as se ss m en t re po rt s M oH , D N D D N D Q u ar te rl y Co un ty G ov er nm en ts N o. o f c ou nt ie s se ns it iz ed o n th e us e of m on it or in g to ol fo r in pa ti en t f ee di ng N o ba se lin e 10 35 Tr ai ni ng R ep or t A tt en da nc e sh ee ts M oH , D N D D N D Q u ar te rl y Co un ty G ov er nm en ts O ut pu t 9. 8 St re ng th en ed te ch ni ca l c ap ac it y fo r cl in ic al n ut ri tio n an d di et et ic s Pr op or ti on o f h ea lt h ca re w or ke rs tr ai ne d on c lin ic al n ut ri ti on p ac ka ge N o ba se lin e 2 0 % 4 0 % Co un ty R ep or t M oH , D N D D N D A n n u al ly Co un ty G ov er nm en ts Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202232 Ta bl e 12 : K RA 1 0 (O ut co m e 10 ) I nd ic at or s O U T CO M E 1 0 : K R A 1 0 1 0 A G R IC U LT U R E A N D F O O D S EC U R IT Y L in ka ge s be tw ee n N ut ri ti on , A gr ic ul tu re a n d Fo od S ec ur it y st re n gt he n ed O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 10 .1 St re ng th en ed s us ta in ab le a nd in cl us iv e fo od s ys te m s th at a re di ve rs e, p ro du ct iv e an d pr of it ab le fo r im pr ov ed n ut ri tio n. N o. o f j oi nt s tr at eg ic p la nn in g m ee ti ng he ld fo r nu tr it io n se ns it iv e ag ri cu ltu ra l pr od uc tio n 1( 20 18 ) 6 8 Po lic y/ st ra te gy / pl an d oc um en t Q u ar te rl y M oA LC M O H D N D , / M O E /C O G / Pa rt ne rs In cl us io n of n ut ri ti on in th e de ve lo pm en t o f a gr ic ul tu re an d fo od s ec ur it y se ct or p ol ic y do cu m en ts N o. o f a gr ic ul tu re p ol ic ie s th at a re n ut ri tio n se ns it iv e by 2 02 2 1( 20 18 ) 6 8 Po lic y/ st ra te gy / pl an d oc um en t A n n u al ly M oA LC M O H D N D , / M O E /C O G / Pa rt ne rs O ut pu t 10 .2 Im pr ov ed a cc es s to n ut ri ti ou s an d sa fe fo od s Pr op or ti on o f f ar m H H p ro du ci ng fo od it em s fr om fi ve fo od gr ou ps fo r s ub si st en ce 35 (2 01 8) 40 60 R ep or ts o n fo od it em s/ Co ns um er in fo re po rt s A n n u al ly M oA LC M O H , C ul tu re So ci al pr ot ec ti on , M O D A , C O G , M O E, P ar tn er s et c. O ut pu t 10 .3 Pr om ot io n of c on su m pt io n of s af e, di ve rs e, a nd n ut ri ti ou s fo od s N o. o f n ew a nd n ut ri ti ou s fo od s pr od uc ts av ai le d in K en ya n m ar ke t 1( 20 18 ) 3 5 Sa fe ty gu id el in es , ne w p ro du ct s br ie fs , Fo od s af et y re po rt s, F oo d co m po si ti on ta bl es , R ec ip es A n n u al ly M o H M oA LC , M O D A & pa rt ne rs O ut pu t 10 .4 St re ng th en ed A gr i n ut ri ti on ca pa ci ti es a nd co or di na ti on at na ti on al a nd co un ty le ve ls N o. o f c ou nt ie s w he re A gr i-n ut ri tio n te ch no lo gi es h av e be en d is se m in at ed 1( 20 18 ) 10 25 Cu rr ic ul um , Te ch no lo gy , A tt en da nc e sh ee ts D is se m in at io n re po rt s A n n u al ly M o H M oA LC & pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 33 Ta bl e 14 : K RA 1 2 (O ut co m e 12 ) I nd ic at or s O U T CO M E 1 2: K R A 1 2 – E D U C A T IO N A N D E A R LY C H IL D H O O D D E V E L O P M E N T (E C D ) N ut ri ti on m ai ns tr ea m ed in E du ca ti on s ec to r po lic ie s, s tr at eg ie s an d ac ti on p la ns O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 12 .1 Po lic ie s, s tr at eg ie s, s ta nd ar ds an d gu id el in es o n nu tr it io n an d ph ys ic al a ct iv it y in s ch oo ls an d ot he r le ar ni ng in st it ut io ns de ve lo pe d an d pr om ot ed N um be r of P ol ic ie s, s tr at eg ie s an d gu id el in es o n nu tr it io n an d ph ys ic al ac tiv it y de ve lo pe d fo r sc ho ol s an d ot he r le ar ni ng in st it ut io ns 2 M oE M oH O ut pu t 12 .2 H ea lt hy a nd s af e fo od e nv ir on m en t pr om ot ed to e ns ur e th at fo od to le ar ne rs is a va ila bl e, s uf fic ie nt , nu tr it io us , a cc es si bl e an d sa fe Pr op or ti on o f s ch oo ls o ffe ri ng s af e an d nu tr it io us fo od s N o B as el in e D at a 4 0 % 6 0 % A ss es sm en t R ep or ts Q u ar te rl y M O E M o H Pr op or ti on o f s ch oo ls w he re n ut ri ti on as se ss m en t i s do ne N o B as el in e da ta 2 0 % 3 5 % A ss es sm en t R ep or ts Q u ar te rl y M O E M o H Ta bl e 13 : K RA 1 1 (O ut co m e 11 ) I nd ic at or s O U T CO M E 1 1: K R A 1 1 – H EA LT H S EC T O R N ut ri ti on in th e H ea lt h Se ct or S tr en gt he n ed O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 11 .1 N ut ri tio n in te gr at ed in h ea lt h po lic y do cu m en ts a nd r ep re se nt ed in he al th s ec to r po lic y de ve lo pm en t fo ru m s Pr op or ti on o f h ea lt h se ct or p ol ic ie s w it h nu tr it io n in di ca to rs in cl ud ed 5 pe rc en t 26 pe rc en t 40 p er ce nt H ea lt h se ct or po lic ie s M oH / D N D M o H O ut pu t 11 .2 N ut ri tio n in te gr at ed in h ea lt h se ct or co or di na ti on m ec ha ni sm s Pr op or ti on o f c oo rd in at io n fo ru m s w he re nu tr it io n is in te gr at ed 2 0 % 4 0 % 6 0 % A nn ua l r ep or ts M oH / D N D M o H O ut pu t 11 .3 Im pr ov ed p er fo rm an ce o f n ut ri tio n w ith in h ea lt h se ct or N o. o f n ut ri ti on in di ca to rs in cl ud ed in th e M in is te ri al p er fo rm an ce c on tr ac ts 1 2 2 H ea lt h le ad er sh ip Pe rf or m an ce co nt ra ct s at N at io na l M oH / D N D M o H Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202234 Ta bl e 15 : K RA 1 3 (O ut co m e 13 ) I nd ic at or s O U T CO M E 1 3 : K R A 1 3 W AT E R , S A N IT AT IO N A N D H YG IE N E ( W A SH ) 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, p la n s an d pr og ra m m es O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 13 .1 R ed uc ed m or bi di ty a nd m or ta lit y du e to c on su m pt io n of w at er fr om un sa fe w at er s ou rc es Pr op or ti on o f h ou se ho ld s us in g an im pr ov ed s an it at io n fa ci lit y 61 .1 K D H S 20 14 67 76 K D H S R ep or t A n n u al ly M oH W A SH H u b D N D Pr op or ti on o f d ea th s at tr ib ut ed to u ns af e w at er s ou rc es 77 .0 8 pe r 10 0, 00 0 (G B D 20 16 ) 65 60 ht tp s:/ /v iz hu b. he al th da ta .o rg A n n u al ly M oH W A SH H u b D N D Pr op or ti on o f h ou se ho ld s w it h ac ce ss to a n im pr ov ed w at er s ou rc e 7 1 K D H S 20 14 77 86 K D H S R ep or t A n n u al ly M oH W A SH H u b D N D O ut pu t 13 .2 N ut ri tio n in te gr at ed in p ol ic ie s, st ra te gi es a nd p la ns o n un iv er sa l ac ce ss to a de qu at e W A SH s er vi ce s Pr op or ti on o f W A SH p ol ic ie s w ith n ut ri tio n co m po ne nt N o B as el in e D at a 77 86 Po lic y do cu m en ts an d st ra te gi es A n n u al ly M O H W A SH H u b D N D O ut pu t 13 .3 R ed uc ti on o f m or bi di ty a nd m or ta lit y du e to p oo r ac ce ss to ha nd w as hi ng fa ci lit y Pr op or ti on o f h ou se ho ld s w it h ha nd w as hi ng s ta ti on in c om po un d 3 5 K D H S 20 14 45 60 K D H S R ep or t A n n u al ly M O H W A SH H u b D N D Pr op or ti on o f d ea th s at tr ib ut ed to la ck o f ac ce ss to h an d w as hi ng fa ci lit ie s 53 .6 p er 10 0, 00 0 (G B D 20 16 ) 49 .5 45 ht tp s:/ /v iz hu b. he al th da ta .o rg A n n u al ly M O H W A SH H u b D N D Ta bl e 16 : K RA 1 4 (O ut co m e 14 ) I nd ic at or s O U T CO M E 1 4 : K R A 1 4 S O C IA L P R O T E C T IO N In te gr at io n o f N u tr it io n in S oc ia l P ro te ct io n P ro gr am m es s st re n gt h en ed O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 14 .1 In cl us io n of n ut ri tio n co m po ne nt in so ci al p ro te ct io n Pr op or ti on o f s oc ia l p ro te ct io n pr og ra m m es w it h a nu tr it io n co m po ne nt 0 (2 01 8) 3 0 % 6 0 % N IM E S an d C P IM S re po rt s A n n u al ly M O H / M L & SP O th er li ne m in is tr ie s D ev el op m en t pa rt ne rs O ut pu t 14 .2 En ha nc ed m on it or in g of n ut ri ti on in s oc ia l p ro te ct io n N um be r of n ut ri ti on in di ca to rs in te gr at ed on th e in fo rm at io n sy st em fo r so ci al pr ot ec ti on p ro gr am m es 0 (2 01 8) 1 2 N IM E S an d C P IM S re po rt A n n u al ly M O H / M L & SP O th er li ne m in is tr ie s D ev el op m en t pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 35 Ta bl e 17 : K RA 1 5 (O ut co m e 15 ) I nd ic at or s O U T CO M E 1 5: K R A 1 5 –M U LT IS E C T O R A L N U T R IT IO N G O V E R N A N CE Ef fic ie nt a nd E ffe ct iv e N ut ri ti on G ov er na nc e, C oo rd in at io n an d Le ga l Fr am ew or ks O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id te rm E nd te rm M ea ns o f ve ri fi ca ti on Fr eq ue nc y Le ad A ss oc ia te d O ut pu t 15 .1 En ha nc ed e xi st in g nu tr it io n co or di na ti on a nd c ol la bo ra ti ng m ec ha ni sm s an d lin ka ge s be tw ee n na ti on al a nd c ou nt y G ov er nm en ts N um be r of fu nc ti on al n ut ri ti on co or di na ti on c om m it te es ’ m ee ti ng s he ld 14 54 90 M ee ti ng m in ut es B i an n u al ly M O H / C O G M O H O ut pu t 15 .2 En ha nc e co or di na ti on in de ve lo pm en t a nd im pl em en ta ti on of r eg ul at or y fr am ew or ks A nn ua l n ut ri ti on s ta nd ar ds a nd r eg ul at io n su m m it w it h re le va nt n ut ri ti on a ct or s N o da ta 3 5 Su m m it re po rt s A n n u al ly M O H / C O G M O H O ut pu t 15 .3 St re ng th en p ar tn er sh ip s fo r nu tr it io n Pu bl ic P ri va te P ar tn er sh ip s tr at eg y de ve lo pe d 0 1 1 R ep or ts B i an n u al ly M O H / C O G M O H O ut pu t 15 .4 En ha nc ed o pp or tu ni ti es fo r co lla bo ra tio n an d jo in t d is co ur se fo r bo th le ve ls o f g ov er nm en t a nd th e se ct or in g en er al N o of A nn ua l L ea rn in g M ee ti ng H el d N o da ta 3 5 R ep or ts – W H IC H R EP O RT S? A nn ua lly M O H /l in e m in is tr ie s/ M O H N o. o f r es ea rc h fu nd fo rm ed 0 1 1 R es ea rc h fu nd re po rt 5 y ea rs D N D Pa rt ne rs Pa rt ne rs N o of R es ea rc h fin di ng s va lid at ed 0 4 8 R es ul ts re po rt s/ pr es en ta ti on s A nn ua lly D N D R T W G N um be r of s ym po si um s/ C on fe re nc es o n nu tr it io n 2 3 5 Sy m p os iu m s A n n u al ly D N D Pa rt ne rs Ta bl e 16 : K RA 1 4 (O ut co m e 14 ) I nd ic at or s O U T CO M E 1 4 : K R A 1 4 S O C IA L P R O T E C T IO N In te gr at io n o f N u tr it io n in S oc ia l P ro te ct io n P ro gr am m es s st re n gt h en ed O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 14 .1 In cl us io n of n ut ri tio n co m po ne nt in so ci al p ro te ct io n Pr op or ti on o f s oc ia l p ro te ct io n pr og ra m m es w it h a nu tr it io n co m po ne nt 0 (2 01 8) 3 0 % 6 0 % N IM E S an d C P IM S re po rt s A n n u al ly M O H / M L & SP O th er li ne m in is tr ie s D ev el op m en t pa rt ne rs O ut pu t 14 .2 En ha nc ed m on it or in g of n ut ri ti on in s oc ia l p ro te ct io n N um be r of n ut ri ti on in di ca to rs in te gr at ed on th e in fo rm at io n sy st em fo r so ci al pr ot ec ti on p ro gr am m es 0 (2 01 8) 1 2 N IM E S an d C P IM S re po rt A n n u al ly M O H / M L & SP O th er li ne m in is tr ie s D ev el op m en t pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202236 Ta bl e 18 : K RA 1 6 (O ut co m e 16 ) I nd ic at or s O U T CO M E 1 6 : K R A 1 6 – M U LT IS E C T O R A L N U T R IT IO N I N FO R M AT IO N S YS T EM S Se ct or al a n d M u lt i se ct or al N u tr it io n In fo rm at io n S ys te m s, L ea rn in g an d R es ea rc h s tr en gt h en ed O ut pu t Ex pe ct ed R es ul ts In di ca to rs B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 16 .1 En ha nc ed n ut ri tio n pl an ni ng a nd pe rf or m an ce m on it or in g an d ev al ua ti on N ut ri ti on s ec to r pl an s pr og re ss r ev ie w ed ev er y qu ar te r 0 10 20 N ut ri ti on M & E do cu m en t Q ua rt er ly re po rt s Q u ar te rl y D N D M O H N um be r of n at io na l n ut ri ti on a nn ua l W or k pl an s de ve lo pe d by 2 02 2/ 20 23 F Y 0 3 5 N ut ri ti on A nn ua l w or k Pl an d oc um en t A n n u al ly D N D M O H N um be r of K en ya N ut ri ti on A ct io n Pl an ev al ua tio n co nd uc te d 0 1 2 K N A P Ev al ua ti on R ep or ts 2 3 y ea rs D N D M O H O ut pu t 16 .2 St re ng th en ed N ut ri ti on s ec to r ca pa ci ty in N IS a nd e vi de nc e ba se d de ci si on m ak in g N um be r of tr ai ni ng s co nd uc te d on N ut ri ti on In fo rm at io n ge ne ra ti on a nd u se 21 4 0 7 4 N ut ri ti on M & E do cu m en t Q u ar te rl y D N D M O H O ut pu t 16 .3 Ti m el y ge ne ra ti on a nd di ss em in at io n of n ut ri ti on si tu at io n up da te s to in fo rm pr og ra m m e pl an ni ng a nd r es po ns e N um be r of n ut ri ti on s it ua ti on r ep or ts (S R A / LR A ) ge ne ra te d 8 13 23 N ut ri ti on M & E do cu m en t A n n u al ly D N D M O H N um be r of u pd at es o f t he p op ul at io n ba se d su rv ey d at ab as e 1 4 8 N ut ri ti on su rv ey d at ab as e A n n u al ly D N D M O H N um be r of ti m es N ut ri ti on w eb si te up da te d 1 30 60 N ut ri ti on w eb si te w w w . nu tr iti on he al th . or .k e B i an n u al ly D N D M O H O ut pu t 16 .4 St an da rd iz ed a nd h ar m on iz ed nu tr it io n da ta c ol le ct io n, m an ag em en t, an d re po rt in g at a ll le ve ls N um be r of n ut ri ti on in fo rm at io n gu id el in es in p la ce 7 8 12 N ut ri ti on M & E do cu m en t A n n u al ly D N D M O H O ut pu t 16 .5 Q ua lit y nu tr it io n da ta g en er at ed fo r ev id en ce b as ed p ro gr am m in g N um be r of N ut ri ti on A ss es sm en ts Va lid at ed 37 6 3 1 4 7 A ss es sm en t re po rt s Q u ar te rl y D N D M O H N o. o f p ol ic y br ie fs g en er at ed to in fo rm pr og ra m m in g/ po lic y ch an ge 5 10 15 Po lic y br ie f pa pe rs A n n u al ly D N D M O H Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 37 O U T CO M E 1 6 : K R A 1 6 – M U LT IS E C T O R A L N U T R IT IO N I N FO R M AT IO N S YS T EM S Se ct or al a n d M u lt i se ct or al N u tr it io n In fo rm at io n S ys te m s, L ea rn in g an d R es ea rc h s tr en gt h en ed O ut pu t Ex pe ct ed R es ul ts In di ca to rs B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 16 .6 En ha nc ed m ul ti se ct or al li nk ag es re su lt in im pr ov ed n ut ri tio n in fo rm at io n ef fic ie nc ie s an d co st ef fe ct iv en es s N o. o f n ut ri ti on s en si tiv e in fo rm at io n lin ka ge s st re ng th en ed 0 1 2 Ag ri c. /F oo ds ec / CH IS / EW S 2 3 Y ea rs D N D M O H N o. o f n ut ri ti on s pe ci fic in fo rm at io n lin ka ge s st re ng th en ed 0 1 2 D H IS / Su rv ei lla nc e/ D H S 2 3 y ea rs D N D M O H O ut pu t 16 .7 Im pr ov ed a cc es s to a nd u se o f nu tr it io n in fo rm at io n to in fo rm pr og ra m m e qu al it y im pr ov em en t N ut ri ti on d as hb oa rd ( w it hi n K H IS ) de ve lo pe d 0 1 1 K H IS N ut ri ti on bo ar d 5 y ea rs D N D M O H N ut ri ti on K H IS s co re ca rd d ev el op ed 0 1 1 N ut ri ti on K H IS sc or ec ar d 5 y ea rs D N D M O H O ut pu t 16 .8 En ha nc ed e vi de nc e ba se d de ci si on m ak in g th ro ug h re se ar ch N o. o f n ew s tr at eg ic n ut ri tio n pa rt ne rs hi ps es ta bl is he d in cl ud in g un iv er si ti es 1 3 5 M o U 2 3 y ea rs D N D M oH R es ea rc h U ni t/ Pa rt ne rs N o. o f n ew r es ea rc h pr io ri ti es id en ti fie d an nu al ly 3 5 8 R es ea rc h in N ut ri ti on Te ch ni ca l W or ki ng G ro up ( RT W G ) m in ut es 2 3 y ea rs D N D Pa rt ne rs N o of c ou nt ie s un de rt ak in g nu tr iti on re se ar ch 0 5 8 Co un ty re se ar ch fin di ng s 2 5 ye ar s D N D / CN C Co un ti es / Pa rt ne rs N o. o f o pe ra ti on al / im pl em en ta ti on al re se ar ch es In iti at ed 8 (2 01 8) 10 12 R es ea rc h pr op os al s va lid at ed 2 3 y ea rs D N D R T W G K EM R I/ Pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202238 Ta bl e 19 : K RA 1 7 (O ut co m e 17 ) I nd ic at or s O U T CO M E 1 7 : K R A 1 – A d vo ca cy , C o m m u n ic at io n a n d S o ci al M ob il iz at io n ( A CS M ) En ha n ce d po li ti ca l c om m it m en t a n d co n ti n ue d pr io ri ti za ti on o f n ut ri ti on in n at io n al a n d co un ty a ge n da O ut pu t 17 .1 Ex pe ct ed R es ul ts In di ca to rs B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d Im pl em en ta tio n of N at io na l ad vo ca cy s tr at eg y on n ut ri tio n N o. o f h ig h le ve l n ut ri ti on m ee ti ng s he ld 0 3 5 R ep or t A n n u al ly M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th N o. o f c ou nt ie s w it h nu tr it io n ad vo ca cy pl an s 0 27 47 R ep or t A n n u al ly M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th N o. o f n ut ri ti on c ha m pi on s id en ti fie d 1 (2 01 5) 6 10 R ep or t A n n u al ly M O H /D N D Co un ti es , N at io na l G ov t, pa rt ne rs O ut pu t 17 .2 In cr ea se d an d su st ai ne d m ul ti se ct or al c ol la bo ra ti on on a dv an ci ng a nd in te gr at in g nu tr iti on o ut co m es a cr os s re le va nt s ec to rs a t n at io na l a nd co un ty N o. o f f un ct io ni ng o f M ul ti s ec to ra l pl at fo rm s 1 (2 01 8) 3 3 R ep or t 2 3 y ea rs M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th O ut pu t 17 .3 So ci al a cc ou nt ab ili ty a nd fin an ci al tr ac ki ng o f n ut ri ti on re so ur ce s at N at io na l a nd co un ty L ev el N o. o f r el ev an t m in is tr ie s an d co un ti es tr ai ne d on n ut ri ti on fi na nc ia l t ra ck in g to ol ( 47 c ou nt ie s an d 13 M in is tr ie s) 16 ( 20 18 ) 49 60 R ep or t B i A n n u al ly M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th N o. o f N at io na l a nd C ou nt y bu dg et s tr ac ke d 16 ( 20 17 ) 4 48 R ep or t A n n u al ly M O H /D N D Li ne M in is tr ie s, Co un ti es Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 39 O U T CO M E 1 7 : K R A 1 – A d vo ca cy , C o m m u n ic at io n a n d S o ci al M ob il iz at io n ( A CS M ) En ha n ce d po li ti ca l c om m it m en t a n d co n ti n ue d pr io ri ti za ti on o f n ut ri ti on in n at io n al a n d co un ty a ge n da O ut pu t 17 .1 Ex pe ct ed R es ul ts In di ca to rs B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d O ut pu t 17 .4 A de qu at e fin an ci al r es ou rc es m ob ili ze d fo r su st ai ne d an d qu al it y nu tr it io n se rv ic es in cl ud in g do m es ti c re so ur ce m ob ili za ti on N o. o f r el ev an t M D A s w it h nu tr it io n bu dg et li ne s N o da ta 5 15 B ud ge t l in e A n n u al ly M O H /D N D M D A s N ut ri ti on m ai ns tr ea m ed in M in is te ri al an d Co un ty p er fo rm an ce c on tr ac t 0 1 2 P C A n n u al ly M O H /D N D M D A s, Co un ti es , C oG , Pe rf or m an ce M an ag em en t an d Co or di na ti on of fic e in E xe cu tiv e of fic e of th e Pr es id en t O ut pu t 17 .5 In cr ea se d an d st re ng th en ed hu m an c ap it al a nd c ap ac it y fo r nu tr it io n ad vo ca cy N um be r of n ut ri ti on p ro fe ss io na ls a nd in flu en ce rs tr ai ne d on a dv oc ac y 0 18 0 30 0 A nn ua lly R ep or t/ ce rt s M O H /D N D Li ne m in is tr ie s, C oG N o. o f n ut ri ti on is ts e m pl oy ed a t n at io na l an d co un ty le ve l 12 00 13 02 13 60 An nu al ly Ad ve rt s/ co nt ra ct s H R R ep or t M O H / D N D / Co un ty go ve rn m en ts PS C, C oG , T N T, CP SB O ut pu t 17 .6 Ev id en ce in fo rm ed n ut ri ti on ad vo ca cy N o. o f n ut ri ti on b es t p ra ct ic es do cu m en te d an d di ss em in at ed 0 15 25 An nu al ly Be st pr ac tic es / ne w sl et te rs M O H / D N D / Co un ty go ve rn m en ts St ak eh ol de rs , Co G , P ar tn er s, N at io na l go ve rn m en t N o. o f s ec to rs a ss is te d in p ac ka gi ng th ei r nu tr it io n ad vo ca cy p ro du ct s 0 6 15 A nn ua lly R ep or ts M O H / D N D St ak eh ol d er s, M D A s O ut pu t 17 .7 St ro ng er r el at io ns hi ps o n nu tr it io n w it h ke y m ed ia ho us es a nd jo ur na lis ts b ui lt a nd m ai nt ai ne d N o. o f m ed ia p er so nn el tr ai ne d (u nd er in flu en ce rs ) 60 ( 20 17 ) 12 0 12 0 Bi a nn ua lly Tr ai ni ng re po rt s / ce rt ifi ca te s M O H /D N D Pa rt ne rs , M ed ia h ou se s N o. o f n ut ri ti on d oc um en ta ri es h el d 0 12 20 Q ua rt er ly R ep or ts M O H /D N D M ed ia , Pa rt ne rs , Co G , N at io na l G ov er nm en t O ut pu t 17 .8 Co m m un it y en ga ge m en t, pa rt ic ip at io n an d fe ed ba ck m ec ha ni sm s in n ut ri ti on se rv ic es a nd d ec is io n m ak in g pr oc es se s st re ng th en ed to en ha nc e so ci al a cc ou nt ab ili ty N o. o f c ou nt ie s w it h fe ed ba ck m ec ha ni sm s on c om m un it y en ga ge m en t 0 30 47 Q ua rt er ly R ep or ts M O H /D N D / Co un ty go ve rn m en ts Co un ti es , St ak eh ol de rs , Pa rt ne rs , Co G , N at io na l G ov er nm en t Ta bl e 19 : K RA 1 7 (O ut co m e 17 ) I nd ic at or s O U T CO M E 1 7 : K R A 1 – A d vo ca cy , C o m m u n ic at io n a n d S o ci al M ob il iz at io n ( A CS M ) En ha n ce d po li ti ca l c om m it m en t a n d co n ti n ue d pr io ri ti za ti on o f n ut ri ti on in n at io n al a n d co un ty a ge n da O ut pu t 17 .1 Ex pe ct ed R es ul ts In di ca to rs B as el in e M id t er m E n d te rm M ea n s of ve ri fi ca ti on Fr eq u en cy Le ad A ss oc ia te d Im pl em en ta tio n of N at io na l ad vo ca cy s tr at eg y on n ut ri tio n N o. o f h ig h le ve l n ut ri ti on m ee ti ng s he ld 0 3 5 R ep or t A n n u al ly M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th N o. o f c ou nt ie s w it h nu tr it io n ad vo ca cy pl an s 0 27 47 R ep or t A n n u al ly M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th N o. o f n ut ri ti on c ha m pi on s id en ti fie d 1 (2 01 5) 6 10 R ep or t A n n u al ly M O H /D N D Co un ti es , N at io na l G ov t, pa rt ne rs O ut pu t 17 .2 In cr ea se d an d su st ai ne d m ul ti se ct or al c ol la bo ra ti on on a dv an ci ng a nd in te gr at in g nu tr iti on o ut co m es a cr os s re le va nt s ec to rs a t n at io na l a nd co un ty N o. o f f un ct io ni ng o f M ul ti s ec to ra l pl at fo rm s 1 (2 01 8) 3 3 R ep or t 2 3 y ea rs M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th O ut pu t 17 .3 So ci al a cc ou nt ab ili ty a nd fin an ci al tr ac ki ng o f n ut ri ti on re so ur ce s at N at io na l a nd co un ty L ev el N o. o f r el ev an t m in is tr ie s an d co un ti es tr ai ne d on n ut ri ti on fi na nc ia l t ra ck in g to ol ( 47 c ou nt ie s an d 13 M in is tr ie s) 16 ( 20 18 ) 49 60 R ep or t B i A n n u al ly M O H /D N D Co G , Co un ti es , L in e M in is tr ie s, H ou se co m m it te e on he al th N o. o f N at io na l a nd C ou nt y bu dg et s tr ac ke d 16 ( 20 17 ) 4 48 R ep or t A n n u al ly M O H /D N D Li ne M in is tr ie s, Co un ti es Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202240 Ta bl e 20 : K RA 1 8 (O ut co m e 18 ) I nd ic at or s O U T CO M E 1 8 : K R A 1 8 – C A PA C IT Y D E V E L O P M E N T Ca pa ci ty to d el iv er a n d de m an d n ut ri ti on s er vi ce s en ha n ce d O ut pu t Ex pe ct ed R es ul ts In di ca to rs B as el in e M id t er m E n d te rm Fr eq u en cy M ea n s of ve ri fi ca ti on Le ad A ss oc ia te d O ut pu t 18 .1 St re ng th en ed s ys te m ic a nd or ga ni za ti on al c ap ac it y de ve lo pm en t o n po lic y, go ve rn an ce , le ad er sh ip , c oo rd in at io n an d pa rt ne rs hi ps fo r nu tr it io n at co un ty a nd n at io na l l ev el N o. o f c ou nt ie s w it h co m pr eh en si ve nu tr it io n ca pa ci ty a ss es sm en ts c on du ct ed 17 30 47 A nn ua lly Ca pa ci ty as se ss m en t re po rt s an d ac ti on p la ns Ca pa ci ty w or ki ng gr ou p D N D a nd im pl em en ti ng pa rt ne rs N o. o f c ou nt ie s im pl em en ti ng th e K en ya nu tr it io n le ad er sh ip a nd g ov er na nc e pr og ra m m e 0 3 4 A nn ua lly A nn ua l re po rt s Ca pa ci ty w or ki ng gr ou p D N D a nd im pl em en ti ng pa rt ne rs O ut pu t 18 .2 En ha nc ed s ys te m s fo r sk ill s an d co m pe te nc y de ve lo pm en t f or nu tr it io n w or kf or ce N o. o f c ou nt ie s ac hi ev in g at le as t 6 0% o f th e p re sc ri be d hu m an r es ou rc e no rm s a nd st an da rd s fo r nu tr it io ni st s 13 24 35 A nn ua lly H R H r ep or ts , Ca pa ci ty as se ss m en t re po rt s A dv oc a cy a nd co m m u ni ca tio ns , Ca pa ci ty w or ki ng gr ou p D N D a nd im pl em en ti ng pa rt ne rs N o. o f c ou nt ie s w it h im pr ov ed s co re c ar d pe rf or m an ce o n nu tr it io n 0 20 40 A nn ua lly Sc or e ca rd re po rt s, D H IS M & E w or ki n g gr ou p , H R IO s D N D , Im pl em en ti ng pa rt ne rs N o. o f c ou nt ie s w he re th e N ut ri ti on In te rn sh ip a nd p la ce m en t g ui de is di ss em in at ed 0 25 47 A nn ua lly A nn ua l re po rt s Ca pa ci ty w or ki ng gr ou p, K N D I D N D a nd im pl em en ti ng pa rt ne rs , O ut pu t 18 .3 St re ng th en ed c ap ac it y fo r co m m un it y le ve l d em an d ge ne ra ti on a nd u ti liz at io n of in te gr at ed n ut ri tio n se rv ic es Pr op or ti on o f C H Vs tr ai ne d on n ut ri ti on pa ck ag es ( m od ul e 8) 1 0 % 4 0 % 8 0 % A nn ua lly CH S re po rt s an d ca pa ci ty as se ss m en t re po rt s CH S fo ca l po in t, ca pa ci ty w or ki ng gr ou p D N D , Im pl em en ti ng pa rt ne rs Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 41 Ta bl e 21 : K RA 1 9 (O ut co m e 19 ) I nd ic at or s O U T CO M E 1 9 : K R A 1 9 – S U P P LY C H A IN M A N A G E M E N T St re n gt h en ed in te gr at ed su p p ly c h ai n m an ag em en t s ys te m fo r n u tr it io n co m m od it ie s a n d a ll ie d t oo ls . O ut pu t Ex pe ct ed R es ul ts In di ca to r B as el in e M id t er m E n d te rm Fr eq u en cy M ea n s of ve ri fi ca ti on Le ad A ss oc ia te d O ut pu t 19 .1 Co un ti es p ri or it iz in g pr oc ur em en t of n ut ri ti on c om m od it ie s an d eq ui pm en t Pr op or ti on o f c ou nt ie s w it h a bu dg et li ne fo r nu tr it io n co m m od it ie s an d eq ui pm en t 3 0 % 4 0 % 5 0 % A nn ua lly Co un ty B ud ge ts D N D Co un ty O ut pu t 19 .2 In cl us io n of n ut ri tio n co m m od it ie s in th e E M L N o. o f n ut ri ti on c om m od it ie s in cl ud ed in th e E M L 17 20 24 2 3 y ea rs E M L L is t D N D Co un ty O ut pu t 19 .3 R ed uc ed c os t f or n ut ri ti on co m m od it ie s an d eq ui pm en t N o. o f n ew c er ti fie d su pp lie rs p ro du ci ng nu tr it io n co m m od it ie s an d su pp ly in g eq ui pm en t 5 8 12 A nn ua lly Li st o f pr eq ua lif ie d su pp lie rs D N D Co un ty O ut pu t 19 .4 Pu bl ic F in an ci al M an ag em en t (P FM ) A ct r ev ie w ed w it h in cl us io n of n ut ri ti on c om m od it ie s Pr op or ti on o f c ou nt ie s w it h dr aw in g ri gh ts at K EM SA fo r nu tr it io n co m m od it ie s an d eq ui pm en t N o da ta (2 01 8) 24 35 B i an nu al ly Pr oc ur em en t an d di st ri bu tio n re po rt s fr om K EM SA D N D Co un ty K E M SA O ut pu t 19 .5 Ex pa nd ed p ro du ct b as e of lo ca lly pr od uc ed n ut ri tio n co m m od it ie s N o. o f n ut ri ti on c om m od it y co or di na ti on m ee ti ng s he ld I nd ic at or d oe s no t r ef le ct th e ex pe ct ed r es ul t 1 10 20 M ee ti ng M in ut es D N D Co un ty O ut pu t 19 .6 Ti m el y Q ua nt ifi ca tio n fo r N ut ri ti on Co m m od it ie s an d eq ui pm en t N o. o f n ut ri ti on c om m od it ie s qu an ti fic at io n an d fo re ca st in g re po rt s ge ne ra te d 1 2 5 Q ua rt er ly Q ua nt ifi ca tio n R ep or ts D N D Co un ty Pr op or ti on o f a nn ua l n ut ri tio n co m m od ity ne ed s m et 5 0 % 6 5 % 8 0 % A nn ua lly D is tr ib ut io n re po rt s D N D Co un ty O ut pu t 19 .7 En ha nc ed c ap ac it y fo r nu tr iti on lo gi st ic s an d in ve nt or y m an ag em en t Pr op or ti on o f c ou nt ie s w it h N ut ri ti on LM IS a nd In ve nt or y M an ag em en t t ra in in g co nd uc te d 4 5 % 5 5 % 6 5 % A nn ua lly Tr ai ni ng re po rt s D N D Co un ty O ut pu t 19 .8 Sa fe a nd q ua lit y n ut ri tio n co m m od it ie s an d eq ui pm en t a t bo th n at io na l a nd c ou nt y le ve l Pr op or ti on o f N ut ri ti on c om m od it ie s an d eq ui pm en t m ee ti ng m in im um q ua lit y an d sa fe ty s ta nd ar ds 7 0 % 7 5 % 8 0 % A nn ua lly Ce rt ifi ca te s of A na ly si s D N D Co un ty Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202242 3.3 Monitoring and Reporting Monitoring of the KNAP activities and results will be done through routine collection, collation, analysis, interpretation and dissemination of data using standardized tools and procedures. The frequency of monitoring the activities will be undertaken monthly, quarterly and annually as outlined in the reporting frequency in the results framework. Monitoring of implementation of programmes will focus on inputs and activities, whereas results monitoring will focus on outputs and outcomes and finally situation monitoring will focus on the status of nutrition, for example undernutrition among under five-year children in Kenya. Each County will have developed CNAP that is context specific but aligned to the KNAP. It is expected that each county will have an M&E Framework within the CNAP to guide the monitoring and evaluation of the programmes in the CNAP and therefore the counties will also monitor activities monthly, quarterly and annually and document the findings. The monitoring will be conducted through the following steps11: reference to the results framework, planning for monitoring, selection of monitoring tools and approaches, data collection and analysis, communication and reporting of findings and taking of corrective action. The monitoring steps are elaborated below: I. Reference to the results framework: The Common Results Framework, the 19 Key Result Areas and process indicators will be the main basis of monitoring. The monitoring activities and resources will hence ensure that data on priority indicators are available. II. Planning for monitoring: This will include deciding on which data will be collected, by when and how. The monitoring plan should link to the monitoring and information system such as Kenya Health Information System, population-based surveys e.g. Nutrition SMART surveys, surveillance systems etc. Key stakeholders at national and county level for example the M&E will need to consult other programs in the Division of Nutrition and Dietetics and County Departments of Health during the planning stage. Resources should also be planned for including human and financial. At this point it is also important to consider how the collected data will be utilized. III. Selection and development of monitoring tools and approaches: Quality data on the indicators in the results framework should be collected using appropriate tools and methods. The NITWG will need to ensure various data collection tools e.g. for routine data and population-based surveys are up to date and relevant for the data collection methods. Development of guidelines and tools is critical and will be aligned to global standards e.g. DHS programmes, SMART methodology, IPC for Acute Malnutrition etc. Joint programme monitoring by government officials and implementing partners will also be useful in establishing progress and providing a mechanism for feedback. IV. Data collection and analysis: In addition to what is covered in chapter 2, data collection will be based on the results framework indicators, cost, technical capacities and national/county level context. The data quality will be evaluated based on minimum criteria established in various national guidelines before performing analysis. The data analysis methods should be aligned to the guidance in the indicator compendium (Annex 2), technical manuals and thresholds. Data analysis should take into consideration gender disaggregation, equity, spatial distribution and disability in as far as this is possible. The findings should be validated by Nutrition Information Technical Working Group (NITWG) using agreed on standards. V. Reporting and communication of findings: Timely reports should be produced upon validation of findings. The findings should first be validated at the county and finally at the national level. For example, Nutrition SMART survey reports should be finalized within 1 month of validating the findings. The reports should be submitted to the Ministry of Health/Division of Nutrition and Dietetics. The reports should be uploaded onto the nutrition website and disseminated to the target audience e.g. Nutrition Technical Forum members using other channels. To ensure improved uptake of findings, user friendly products such as short visual synopsis will be produced and disseminated using effective channels of communication. Figure 9 below illustrates the reporting cycle of routine data from Kenya Health Information System as well as from the community level to the national level and also the feedback mechanism from the national to the community level. 11 UNICEF (2017): Results Based Management Handbook – Working together for children. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 43 Figure 9: Reporting cycle of routine data-KHIS VI. Taking corrective action: The evidence generated will inform the kind of corrective action to be taken by various programmes and stakeholders to promote accountability and realization of results. Corrective actions may include the following: • Making changes to what is being done and how it is being done e.g. scale up and scale down of activities. • Allocating resources more appropriately to emerging needs. • Building capacity on various technical areas. • Re-orienting advocacy and policy influencing. VII. Quarterly and Annual multisectoral and multi-stakeholder nutrition reviews (AMNRs): The focus will be on the progress of activities, processes and outputs in the annual work plans (Annex 6). The national level and counties are expected to conduct quarterly reviews using routine data from KHIS, Nutrition scorecard, field visits, implementation progress reports, technical working group coordination meetings feedback etc. The review meetings will have representation from various ministries and nutrition stakeholders such as NGOs, UN agencies, academia etc. Review meetings will take place at national and county levels as well as though regional meetings12 for learning exchange. Review reports at national and county levels outlining progress will be produced and corresponding recommendations implemented and follow up made. Detailed process monitoring indicator matrix for each KRA is presented in the M&E Process Monitoring Template uploaded at the MOH nutrition website http://nutritionhealth.or.ke.resources for easy access. 12 The regional clusters will include several counties coming together to learn and share best practices Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202244 3.4 Monitoring and Evaluation Implementation Matrix The monitoring and evaluation implementation matrix for the key performance indicators is shown in Table 22. Table 22: Monitoring and Evaluation Implementation Matrix Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Nutrition plans progress reviewed to inform planning and program adjustment National annual Work plans developed by 2022/2023 FY Develop annual work plans Planning meetings within the programmes X X X X X Joint planning meetings with Partners X X X X X Sharing the tentative work plan with the partners for resource mobilization X X X X X A nutrition multiyear plan 2023 2027 (KNAP) developed Develop a National Nutrition Action Plan for 2023 2027 Planning Meetings within the programmess X Nutrition stakeholders’ workshops X Technical assistance during NNAP development X Designing and printing the KNAP document X Launching the developed KNAP X A Kenya Nutrition M&E Framework for the 2018/2022 KNAP in place by end of 2018/2019 FY Develop a Kenya Nutrition M&E framework for the 2018 2022KNAP Planning Meetings within the programmess X Holding Nutrition M&E framework development workshops X Technical Assistance during M&E framework development X Launch Nutrition M&E Framework X A Kenya Nutrition M&E Framework for the 2023/2027 KNAP in place by end of 2022/2023 FY Develop a Kenya Nutrition M&E framework for the 2023-2027 KNAP Planning Meetings within the programmess X Holding Nutrition M&E framework development workshops X Technical Assistance during M&E framework development X Launch Nutrition M&E Framework X National annual reports developed by 2022/2023 Develop national annual reports Report writing workshops X X X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 45 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 An annual KNAP Review Review KNAP implementation progress annually Review meeting at national level to review progress and prepare for country wide review meeting X X X X Develop improvement plan based on progress, field experience and lessons learnt X X X X Develop a score card to ease tracking of KNAP implementation progress X X X X Regional (cluster) review workshops with counties and other stakeholders X X X X A mid-term evaluation conducted by 2020/2021 FY Mid-term Review of the KNAP implementation progress Planning meetings for the mid-term review X Development of the mid term review TOR X Technical assistance for mid-term review (consultancy) X Desk top reviews X Field visits to collect data/ conduct interviews X National level stakeholder consultative forum validation of findings X Develop mid-term report with improvement plan X Generate a score card to track progress X Dissemination meeting for the KNAP mid-term review findings X An end term evaluation for the 2018/2022 KNAP conducted by 2022/2023 An End-term Review of the KNAP implementation progress Planning meetings for the end term review X Development of the end term review TOR X Technical assistance for end term review (consultancy) X Desk top reviews X Field visits to collect data/ conduct interviews X National level stakeholder consultative forum validation of findings X Develop end term report with recommendations for the 2023-2027 KNAP X Dissemination meeting for the KNAP End term review findings X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202246 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Strengthened Nutrition sector capacity in NIS and evidence-based decision making 200 health workers and managers trained/ sensitized on nutrition dashboards and scorecards Sensitization and capacity development for national and counties on nutrition dashboards and scorecards Planning meetings for the training X X X Technical assistance / support X X X X Prepare training Package X Training workshop for nutrition dashboards and score cards X X Update capacity development training template for updating of the IHRIS X X 15 officers trained on website maintenance and management by 2022 Train officers on website Maintenance and management Planning meetings for the training X X Technical assistance / support X X Review of the training Package X X Training workshop for website maintenance X X Update capacity development training template for updating of the IHRIS X X 90 officers trained on qualitative research methodology by 2022 Train Officers on Qualitative Research Methodology, Data collection, Analysis and Report writing Planning meetings for the training X X X Technical assistance / support X X X Review of the training Package X X X Training workshop for Qualitative Research Methodology X X X Update capacity development training template for updating of the IHRIS X X X 75 officers trained on SMART survey methodology by 2022 Train Officers on SMART Survey Methodology Planning meetings for the training X X X Review of the training Package X X X Training workshop on SMART Methodology X X X Update capacity development training template for updating of the IHRIS X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 47 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 350 officers trained on IPC for acute malnutrition by 2022 Train Officers on Integrated Phase Classification for Acute Malnutrition Planning meetings for the training X X X X X Review of the training Package X X X X X Training workshop on IPC for Acute Malnutrition X X X X X Update capacity development training template for updating of the IHRIS X X X X X 60 officers trained on coverage methodology by 2022 Train on Coverage Methodology Planning meetings for the training X X Technical assistance / support X X Review of the training Package X X Training workshop on Coverage Methodology X X Update capacity development training template for updating of the IHRIS X X 240 officers trained on nutrition data elements and indicators in the KHISKHIS Train Officers on Nutrition data elements and indicators in the KHISKHIS Planning meetings for the training X X X X X Technical assistance / support X X X X X Review of the training Package X X X X X Training workshop on Nutrition data elements and indicators in the KHISkKHIS X X X X X Update capacity development training template for updating of the IHRIS X X X X X 70 officers trained on sentinel surveillance (EWS) Train Officers on Sentinel Surveillance Early Warning System Planning meetings for the training X X Review of the training Package X X Training workshop on Sentinel Surveillance-Early Warning System X X Update capacity development training template for updating of the IHRIS X X Semi-annual data review and feedback meetings held with counties Routine Data review and feedback meetings with counties Planning meetings with the stakeholders X X X X X Data analysis and preparation of feedback package/slides X X X X X Hold semi-annual review meeting - utilize ICT e.g. conference calls, skype etc. X X X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202248 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 An NIS/M&E needs assessment conducted by 2019/2020 Conduct M&E needs assessment Assessment planning meetings X Questionnaire protocol development X Conduct online survey on NIS Gaps/needs X Generate a needs assessment report X Technical assistance requirement report in place Map NIS areas requiring additional technical assistance Develop technical assistance requirement report X X X X An NIS/M&E action plan developed by 2019/2020 develop action plan based on the assessment findings Dissemination and development of the Action plans to address the needs X Develop a scorecard to track the key actions X X X X Expected Output: Standardized and harmonized nutrition data collection, management, and reporting at all levels A Kenyan Nutrition Coverage Guideline in place Finalize the Kenyan Nutrition Coverage Guideline Input comments from internal and external reviewers X Present the Final document for approval and signing X Designing and printing X Dissemination/ sensitization/Launch meetings X A National DQA guideline for Nutrition Indicators in the KHIS developed by 2020 Develop a DQA guideline for nutrition indicators in the KHIS Guideline development working meetings X Pilot/pre-test the DQA guidelines X Finalize the guideline for use X Designing and printing X Dissemination/ sensitization/Launch meetings X SOP for the Sentinel Sites DQA reviewed by 2018/2019 Review SOPs/ Sentinel sites DQA guidelines SOPs/Sentinel sites DQA guidelines review meetings X X Pilot/pre-test the SOPs/ Sentinel sites DQA Guidelines X X Dissemination through existing structures X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 49 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 An MIYCN KAP Field assessment manual in place by end of 2019/2020 FY Finalization of the MIYCN KAP Field assessment manual Manual Review workshop X X Share with the Internal and External reviewers for input X X Input comments from internal and external reviewers X X Present the Final document for approval and signing X X Designing and printing X X Dissemination/ sensitization/Launch meetings X X HMIS Indicator manual review supported Participate in the HMIS indicator manual review Attend Review meetings X X Internal Working meetings on the nutrition indicators in the HMIS manual X X A Guideline for County Nutrition Action Plan development in place Develop a guideline for the CNAP development Technical meetings for development of the guideline X An IYCF-e Assessment tools and guidelines package reviewed by end of 2018/2019 FY Review IYCF-e assessment tools and guidelines package Technical Assistance in the review X Review and validation by the NITWG X Pilot the tools to make recommendations based on the field experience to feed into the assessment manual X KKHIS Tools reviewed Review KHISKHIS Tools Planning meetings X Review workshops X SMART Survey Questionnaire revised (MS word and ODK version) Review SMART Survey Questionnaire Review meetings X X X X X KAP Survey (MIYCN) Questionnaire reviewed (MS word and ODK version) Review KAP survey Questionnaire Review meetings X X NIS/M&E tool and guideline packages printed Print NIS/M&E tools and guidelines Designing and printing X Pre-test NIS/ M&E tools and guidelines Pre-test and feedback questionnaire based on the findings X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202250 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 NIS/M&E tool and guideline packages distributed Distribute NIS/ M&E tools and guidelines Preparation of the distribution plan X Distribution of the tools X NIS/M&E tool and guideline packages disseminated Disseminate NIS/M&E tools and guidelines Dissemination meetings X Expected Output: Timely generation and dissemination of nutrition situation updates to inform programme planning and response Bi-annual nutrition situation reports developed during seasonal assessments by 2022/2023 Develop bi annual nutrition situation reports Data Collation and Analysis X X X X X Develop situation maps X X X X X Develop situation briefs and infographics X X X X X Update caseload tracker X X X X X Develop full situation report X X X X X Disseminate findings at Kenya Food Security Meeting (KFSM), Emergency Nutrition Advisory Committee (ENAC) and other TWGs for response planning X X X X X Monthly nutrition situation update reports shared Share monthly nutrition situation updates Monthly routine nutrition data analysis X X X X X Share feedback with the counties through emails, calls etc. X X X X X Nutrition website updated on a monthly basis Update nutrition website on a monthly basis Gather and Review/ approve the final products for uploading X X X X X Uploading of the final product X X X X X Population based survey database updated semi annually Update population based survey database monthly Data mining from the reports X X X X X Update the worksheets X X X X X Upload the updated worksheet on the nutrition website X X X X X NIS/M&E Best practices annual report shared annually Share best practices annual report Form a best practice validation task force and TOR X X X X X Prepare a best practice evaluation criteria X X X X X Call for submission of Best practices X X X X X Evaluate submitted Best practices X X X X X Publish the scalable best practices for learning X X X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 51 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Quality nutrition data generated for evidence-based programming Nutrition data clinic workshops held Conduct nutrition data clinic and hold review meetings Planning meeting X X X X X Hold data clinic workshops X X X X X Write data clinic report with action points and timelines X X X X X Hold data clinic action point review meetings X X X X X Nutrition data quality audits conducted Conduct KHISKHIS nutrition data quality audit Conduct KHIS DQA Planning meetings X X X X X Develop KHIS DQA protocol with budget X X X X X Conduct KHIS DQA at field level X X X X X Write KHIS DQA report X X X X X Disseminate findings and develop improvement plan X X X X X Monitor progress of improvement plan X X X X X Conduct LMIS nutrition data quality audit Conduct LMIS DQA Planning meetings X X X X X Develop LMIS DQA protocol with budget X X X X X Conduct LMIS DQA at field level X X X X X Write LMIS DQA report X X X X X Disseminate findings and develop improvement plan X X X X X Monitor progress of improvement plan X X X X X Conduct EWS/sentinel surveillance nutrition data quality audit Conduct EWS DQA Planning meetings X X X X X Develop EWS DQA protocol with budget X X X X X Conduct EWS DQA at field level X X X X X Write EWS DQA report X X X X X Disseminate findings and develop improvement plan X X X X X Monitor progress of improvement plan X X X X X Nutrition SMART, MIYCN KAP and Coverage Survey Methodologies reviewed Review Nutrition SMART, MIYCN KAP and Coverage survey methodologies in monthly NITWG Nutrition SMART, MIYCN KAP and Coverage Survey methodologies reviewed in NITWG meetings X X X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202252 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 Nutrition SMART, MIYCN KAP and Coverage Survey results validated Review and validate Nutrition SMART, MIYCN KAP and Coverage Survey results in monthly NITWG Nutrition SMART, MIYCN KAP and Coverage Survey results reviewed in monthly NITWG meetings X X X X X 20 Quality Integrated Nutrition SMART Surveys conducted annually in the ASAL counties to inform nutrition situation Conduct Integrated Nutrition SMART Surveys Planning for the SMART Survey; Training of Data collectors; Field work; Data Analysis Reporting Validation and dissemination X X X X X 15 Quality MIYCN KAP Surveys conducted every 3 years Conduct MIYCN KAP Surveys Planning for the KAP survey Training of Data collectors Field work Data Analysis Reporting Validation and dissemination X 15 Quality Coverage Surveys conducted every 3 years in the ASAL Counties in Kenya Conduct Coverage Surveys Planning for the Coverage Survey Training of Data collectors Field work Data Analysis Reporting Validation and dissemination X Expected Output: Improved multi-sectoral nutrition information efficiencies and cost-effectiveness through enhanced linkages Number of nutrition sensitive information linkages strengthened Ensuring collaborations with nutrition sensitive sectors for nutrition sensitive information Conduct initiation meetings and identify entry points for linkages/collaboration X X X X X Regular participation of NITWG focal points in nutrition sensitive coordination fora/TWGs X X X X X Annual review of effectiveness/achievements of enhanced multisectoral linkages X X X X X Number of nutrition specific information linkages strengthened Ensuring nutrition specific information collaborations Conduct initiation meetings and identify entry points for linkages/collaboration X X X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 53 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 Regular participation of NITWG focal points in nutrition specific coordination fora/TWGs X X X X X Annual review of effectiveness/achievements of enhanced nutrition specific linkages X X X X X NIS/M&E Terms of References reviewed annually Review and update NITWG ToR Review, update, and validation of ToR in NITWG X X X X X Regular monitoring of NITWG Annual Plans Quarterly review and presentation of NITWG Annual Plan progress X X X X X Identification of solutions to key gaps and bottlenecks identified during review X X X X X Proportion of funds secured for NIS/M&E activities Annually Securing resources for NITWG priorities Resource mapping of current NITWG priorities X X X X X Identification of key resource gaps and possible funding sources X X X X X Inclusion of unfunded nutrition information priorities into ACSM X X X X X Number of multisectoral meetings conducted Participate in multisectoral meetings Participate in multisectoral meetings X X X X X Expected Output: Improved access to and use of nutrition information for programme quality improvement Number of national Data Protection Guidelines with nutrition sector inputs included Ensure nutrition sector participation in development and updating of Data Protection Guidelines Linkage with MoH on Data Protection guideline development process X X X X X Regular participation of NITWG focal point in guideline development meetings and process X X X Updated Data Protection Guideline progress and guidance disseminated through focal point X Nutrition included in KHO Nutrition sector participation in KHO NITWG and RNTWG focal points regularly participate in KHO TWG X X X X X Continued advocacy for inclusion of nutrition dashboard in KHO X X X X X Nutrition dashboard (within KHIS) developed Nutrition dashboard participation in Health and Demographic Surveillance Systems (HDSS) initiatives Regular participation of NITWG focal points in HDSS meetings and TWG X X X X X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202254 Key Performance Indicators Activities Sub Activities Timeline (s) 2018/19 2019/20 2020/21 2021/22 2022/23 Ensure prioritization of support for development of nutrition dashboards X X Develop and roll out of nutrition specific dashboards Formation of Task Force for DHIS Nutrition Dashboards X Task Force to propose dashboards for different programme areas/ priorities X Validation of dashboard proposals by NITWG X Development of nutrition dashboards (IMAM, MIYCN, MN, Commodities, etc.) with HIS support X X X Pilot of Nutrition Dashboard at national and county level X Nutrition KHIS scorecard developed Develop and roll out Nutrition KHIS scorecard Formation of Task Force for KHIS scorecard X Task Force to propose scorecards for different programme areas/ priorities X Hold consultative meetings with nutrition programme officers X Validation of the DHIS nutrition scorecard by NITWG X Pilot of Nutrition Scorecard at national and county level X Number of counties utilizing nutrition dashboard to improve programme quality Implementation and roll out of nutrition dashboards and scorecards to inform programme performance Sensitization and capacity development for counties on nutrition dashboards and scorecards X X X X Use of nutrition dashboards and scorecards in county level programme review meetings, including CNTF, CHMT, MCNP Regional Meetings, etc X X X Development of county level action plans based on gaps and issues identified X X X Regular review and monitoring of progress on resolution of bottlenecks and improvements in action plans X X X Lessons learned/best practices review at national and county levels X X Update of nutrition dashboards and scorecards as informed by review meetings and feedback X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 55 3.5 Evaluation The aim of an evaluation is to determine the relevance, impact, efficiency, effectiveness and sustainability of interventions and the contribution of the programme to results (UNICEF 2017). Evaluation provides credible evidence - based information to help nutrition sector continually improve its performance, learning and accountability. The main evaluations will be Mid Term Review (MTR), End Term Review (ETR), quarterly reviews and specific programme evaluations. • Mid -term review: A midterm review (MTR) of the Kenya Nutrition Action Plan will be done in 2020 to review the progress made in the two years of implementation and recommend adjustments in strategy or review of expected targets if deemed necessary. It will also be aligned to the health sector strategic plan midterm review. It will cover all the targets mentioned in the plan, including targets for outcome and impact indicators. The results will be used to adjust the KNAP strategies, priorities and targets. • End term evaluation: The end-term review (ETR) of the Kenya Nutrition Action Plan will be done in 2022 to evaluate the overall performance of the KNAP and use lessons learnt to develop the subsequent KNAP and review the final achievements of the sector against what had been planned. It will involve a comprehensive analysis of progress and performance for the whole period of the plan. • Specific programmes evaluations – This will focus on specific interventions, policy, strategy etc. To guide the evaluations in nutrition sector, a costed evaluation plan will be developed. The costed evaluation plan will provide the following details: proposed title of the evaluation, start and end dates, cost, source/s of funds, responsible programmes for conducting and tracking of progress. Evaluations are rigorous and hence a realistic plan is recommended. Evaluation steps: During an evaluation process, the following seven steps will be followed: I. Assess the utility, necessity and evaluability of the evaluation. This includes examining the design of the programmes, project, and strategy etc, availability of monitoring information, accountability and conduciveness of the context. II. Plan and commission the evaluation – allocate responsibility and develop terms of reference (TORs). The TORs should include context of the evaluation, purpose of evaluation, scope, evaluation criteria, key evaluation questions, methodology, work plan and budget, products and reporting, management arrangements and dissemination plan. According to OECD-DAC13, the key evaluation criteria are relevance, impact, efficiency, effectiveness and sustainability. Additional evaluation criteria depending on need include equity, gender and human rights. During humanitarian situations, it is also important to consider coverage of interventions, coordination and coherence. III. Manage the inception phase – this should be implemented within 1 month. The evaluation team should provide a report outlining the revised work plan, understanding of the TOR and agreed evaluation methodology. IV. Data collection, analysis and validation of findings. V. Disseminate and use evaluation findings – packaging of evaluation findings and using of strategic dissemination forums relevant to target audience to increase uptake of evaluation findings. VI. Prepare and track the implementation of evaluation recommendations. VII. Use evaluation for learning and accountability. 13 Organisation for Economic Co-operation and Development’s (OECD) Development Assistance Committee (DAC) Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202256 3.6 Accountability and Learning Accountability: refers to the transparency of processes including planning, execution and reporting. This will: • Ensure stakeholders are responsible for resources and results. • Help decision makers to identify and track areas of greatest need to help achieve targets • Serve as an advocacy tool for external partners and stakeholders • Stimulates discussion among key players, benchmark and encourage cross learning among counties, aid to unmask disparities across counties and encourage social accountability and mutual dialogue with key players (multiagency, multi-sectoral and across all levels) to address malnutrition. The M&E framework outlines the following strategies to ensure accountability: 1. Accountability on the side of the Division of Nutrition and Dietetics o Accountability for funds o Accountability for results o Social accountability How? o Annual review meetings through the Nutrition Technical Forum o Regular review meetings by the programme managers o Stakeholder engagement in every step of implementation of the KNAP inputs o Timely publication and wide dissemination of reports, guidelines and relevant documents o Kenya Nutrition Scorecard and the RMNCAH scorecard 2. Accountability by the county government Authorities (S/CHMT, S/CO-MOA, NDMA etc.) o Accountability for funds o Accountability for results Social accountability How? o Actions taken to improve nutrition indicators using the RMNCAH scorecard and Kenya nutrition scorecard o Financial tracking using the financial matrix o Data Quality Assurance activities like audits and review meetings o Joint supportive supervision and mentorship o Generation and dissemination of annual work plan reports o Kenya Nutrition Scorecard and the RMNCAH scorecard o Community feedback mechanisms and dialogues. Information sharing with the communities, using the relevant forums 3. Accountability by the partners o Accountability for funds o Accountability for results o Social accountability How? o Joint planning and execution of programme activities o Joint budget reviews and reporting with the relevant platforms o Information sharing with the communities, using the relevant forums o Information to be more user-friendly and accessible to the public and encourage public oversight through proactive engagement o Stakeholder engagement in every step of implementation of the KNAP inputs o Timely publication and wide dissemination of reports, guidelines and relevant documents Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 57 4. Accountability by Health Facilities (Health Workers, Health Facility committee etc.) o Accountability for allocated resources o Accountability for results o Social accountability o Hold regular monitoring and review of activities o Coordination meetings by the health facility committees o Community feedback mechanisms and dialogues. Information sharing with the communities, using the relevant forums 5. Accountability by the Community (Community Units, Community Leaders and Community Health Volunteers) o Hold regular monitoring and review of community led actions o Monitor effectiveness of the complaint and feedback mechanism o Communicate feedback to the community, encouraging them to respond in turn Accountability Tools and Processes: o Community score cards o Participatory approaches: Community dialogues and Action days o Joint monitoring o Confidential Complaint and Feedback mechanism o Kenya Nutrition Scorecard Learning: Refers to the process through which information generated from M&E is reflected upon, and intentionally used to continuously improve a plan/strategy to achieve results. The learning process of the Kenya M&E Framework will adopt the adaptive management cycle approach stipulated in the KNAP, which involves improving outcomes through learning14. There will be implementation of the strategies and interventions to address the issues identified during the review of NNAP 2012-2017. Learning will involve assessing what works well in a context or what does not work well, and which aspects have more influence on the achievement of results, which strategies can be replicated etc. Approaches to guide in learning: 1. Compare results across time to determine which ones contribute to achieving the set tasks and expected results. 2. Facilitation of both levels of learning through formal or informal learning and reflection meetings of all stakeholders, by sharing learning experiences (positive and negative) with partners, communities, and other stakeholders, in response to their needs: • Organize workshops to reflect on lessons learned and to exchange good practices e.g. Regional meetings, which promote events for horizontal knowledge exchange by the counties. • Ride on community dialogue days to share lessons learned and reflect on best practices 3. Documentation of processes and reports, and appropriate storage of MEAL outputs to keep learning within the programmes and sectors even in absence of the key staffs. • Filing Paper based report • Majorly uploading soft copies (photos, videos) on the nutrition website 4. Learning needs assessment and support • Mentoring of staff with a focus on specific issues or identified needs and help individuals reflect and question existing practice. • Training courses in response to feedback. 14 The Kenya Monitoring and Learning Cycle Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202258 3.7 Operational Research Operational research is any research producing practically any usable knowledge (evidence, findings, information etc.) which can improve programme implementation (e.g. efficiency, effectiveness, quality, scale up, access and sustainability) regardless of type of research (design, methodology)15. Operations research typically tries to modulate inputs and processes in programmes and aims to measure desired changes in outputs, outcomes and impacts. For example, research in determining whether combining cash-based interventions and nutrition counselling can improve breast feeding and complementary feeding outcomes. Operational research is useful in providing context specific answers e.g. how does a proven intervention work in a different context? It helps to explain success and failure. Operations research uses mixed methods approaches that are often interlinked and can be broadly divided into two: • Secondary data analysis • Primary level research – this can take different forms: − Exploratory/diagnostic focusing on problem identification e.g. formative or needs assessment. − Field intervention – quasi experimental and randomized cluster trails. − Evaluative and cost effectiveness studies. The nutrition research activities will be coordinated through the Research in Nutrition Technical Working Group (RNTWG) with linkages to relevant programmes and the relevant counties16. The working group will review, approve, facilitate and promote implementation of research of highest quality in nutrition to inform policy. Annex 4 is a guide for submitting research proposals to the technical working group. It is recommended that the technical working group validates research findings and disseminate effectively to target audience to increase uptake of research findings. 15 Sumit Malhotra (2010): Operations Research in Public Health 16 Relevant counties refer to the counties where the operational research will be carried out 5. Development of innovative tools for MEAL • Online learning 6. Feedback mechanism Figure 10 : Learning Cycle Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 59 3.8 Research and Learning Implementation Matrix The research and learning implementation matrix is presented in Table 23. Table 23: Research and Learning Implementation Matrix Key Performance Indicators Activities Sub Activities 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Strategic partnerships and linkages developed Number of New Strategic research Partnerships established annually Map out all the partners and networks including research institutions, universities, ethical research committees etc. that conduct research Desk review to map partners and identify expertise X X X X X Expected Output: Linkages on research in nutrition strengthened Number of existing research partnerships strengthened by 2022/23 Identify expertise for research in nutrition from existing partnership RNTWG meetings X X X X X Expected Output: Research priorities identified through established Linkage between county and national government and other sectors; Number of new research priorities identified annually Desk reviews RTWG meetings X X X X X Expected Output: Research priority areas identified and mainstreamed/consolidated into national and county priority agenda; Number of research priority mainstreamed in national Agenda Needs assessment at national level to identify priorities Consultative meetings X X X X X Expected Output: Sub-committees for research established and strengthened Number research priority mainstreamed in county agenda annually Research Proposals presented and validated RTWG X x x x x Expected Outcome: Collaboration and partnerships with other TWGs involved in Research strengthened Two subcommittees on research established annually Develop concept noted on research prioritization and importance of evidence in decision making Lobby counties to establish own research committees X x x x x Number of collaborations with Research TWG by 2022 Hold collaborative meetings Collaborative RTWG Meetings X x x x x Expected Outcome: Conduct of research improved and increased Number of operational / implementation researches conducted by 2023 Review and validate research proposal submitted to the RTWG RTWG Meetings X x x x x Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202260 Key Performance Indicators Activities Sub Activities 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Research skills and capacity developed Number of people trained on Research skills in three research methodologies developed by 2022 Trainings on research skills X x x Expected Output: Research fund is established One research fund formed by 2022 Concept notes and grant applications X x x x x Expected Outputs: 1. Quality and standards for conduct of research improved 2. Research studies, methodologies and results validated Number of Standard Operating Procedures on conduct of research developed by 2022 Desk review and Mapping out existing SoPs/ guidelines, standards that support research in nutrition RTWG meetings X x x x x Number of Research findings disseminated to county where research was undertaken by 2022 Review and validate and disseminate research findings submitted to the RTWG RTWG meetings X x x x x Expected Output: Research findings disseminated to decision/policy makers Systematic review of nutrition research findings strengthened Review and disseminate research findings County meetings for dissemination by county teams x x x Four systematic reviews of nutrition research findings (MIYCN, Capacity, SMART, coverage) conducted by 2022 Included in the M and E section Included in the M and E section x x x x x Expected Output: Symposiums and conferences organized No. of symposiums/ Conferences on nutrition held by 2022 Organize for symposium/ conference Conduct Research in Nutrition Symposium every 2 years x x Expected Output: Knowledge platform designed and developed One knowledge management platform on research on Nutrition established Develop a knowledge platform work plan Identify sources for knowledge platform content; Resource mobilize for design, set up and management of knowledge platform x x x x x Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 61 Key Performance Indicators Activities Sub Activities 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Nutrition and dietetics research data integrated into Nutrition and other allied portals Research data integrated in two portals by 2022 Lobby for inclusion of nutrition and dietetics information into other allied portals x x x x x Expected Output: Communities of practice / Best Practice forums in research in nutrition established Number of community of practice forums established by 2022 Establish and maintain national committee for community of practice in an identified area Consultative meetings; identification of possible communities of practice x x x x x Expected Output: Linkages strengthened Number of Linkages with universities to share research findings established by 2022 x x x x X Expected Output: Research repository platform designed and developed Number of Research Repository developed by 2020 Design and develop the research repository platform; Map researches available from different institutions; x x x x X Desk Review quality of findings from the research to select most plausible; x x x x X Meetings to discuss research findings for inclusion in research repository; x x x x X Resource mobilize and Maintain and update research repository; x x x x X Sensitize on the importance of common research repositories x x x x X Expected Output: Increased access to research findings for decision making Number of researches disseminated Dissemination of research findings in conferences; meetings; workshops Research dissemination workshops x x x x X Expected Output: Open data access policies /guidelines developed Open data access guideline/policy developed by 2022 Develop open data access guidelines x x x x X Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202262 Key Performance Indicators Activities Sub Activities 2018/19 2019/20 2020/21 2021/22 2022/23 Expected Output: Open data access systems put in place One open data access portal established by 2022 Design and develop data access portal RTWGs meetings x x x x X Expected Output: Capacity on knowledge translation developed for increased capacity for translation No. of Persons trainied/sensitized onon knowledge translation annually Capacity building on knowledge translation Develop policy brief as outputs of knowledge translation training x x x x X Expected Output: Systematic review strengthened Number of policy briefs/statements translated from research findings annually Train on systematic review processes Produce systematic reviews as outputs of the systematic review training x x x x X Expected Output: Development of a nutrition journal initiated A nutrition journal developed by 2022 Develop a nutrition journal development work plan Identify key stakeholders for development of journal; Identify potential journal reviewers and editors; Plan for registration of journal x x x X Expected Output: Research finding published in various journals Number of nutrition manuscripts published in various journals using sector data by 2022 Identify data/ findings for publication Develop manuscripts for publishing in the nutrition journal x x x x Expected Output: Innovations in research in nutrition increased One innovation in research in nutrition developed Identify potential innovations in research in nutrition; Resource mobilize for innovations in research in nutrition x x x x X Best Practices: is “knowledge about what works in specific situations and contexts, without using inordinate resources to achieve the desired results, and which can be used to develop and implement solutions adapted to similar health problems in other situations and contexts”. Criteria for Selection of “Best Practices” are as follows: o Effectiveness: This is a fundamental criterion: the practice must work and achieve measurable results. o Efficiency: The proposed practice must produce results with a reasonable level of resources and time. o Relevance: The proposed practice must address the priority health problems in the country o Ethical soundness: The practice must respect the current rules of ethics for dealing with human populations. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 63 o Sustainability: The proposed practice must be implementable over a long period without any massive injection of additional resources. o Possibility of duplication: The proposed practice, as carried out, must be replicable elsewhere in the Country. o Involvement of partnerships: The proposed practice must involve satisfactory collaboration between several stakeholders. o Community involvement: The proposed practice must involve participation of the affected communities. o Political commitment: The proposed practice must have support from the relevant national or local authorities. Key components of documenting Best Practices (See ANNEX 3: Good Practice Template) a) Title of the “Best Practice”: This should be concise and reflect the practice being documented. b) Introduction: This should provide the context and justification for the practice and address the following issues: a. What is the problem being addressed? b. Which population is being affected? c. How is the problem impacting on the population? d. What were the objectives being achieved? c) Implementation of the Practice a. What are the main activities carried out? b. When and where were the activities carried out? c. Who were the key implementers and collaborators? d. What were the resource implications? d) Results of the Practice – Outputs and Outcomes a. What were the concrete results achieved in terms of outputs and outcomes? b. Was an assessment of the practice carried out? If yes, what were the results? e) Lessons Learnt a. What worked really well – what facilitated this? b. What did not work – why did it not work? f) Conclusion a. How have the results benefited the population? b. Why that particular intervention should be considered a “Best Practice”? c. Recommendations for those intending to adopt the documented “Best Practice” or how can it help people working on the same issue(s). g) Further Reading: Provide a list of references that give additional information on the “Best Practice” for those who may be interested in how the results have benefited the population. Methods of disseminating and sharing Best Practices o Publication to promote learning and sharing of experience o Uploading on the nutrition website and providing the web link through email notification to the relevant stakeholders o Presentation in conferences, symposia and forums o Use other methods as appropriate Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202264 IMPLEMENTATION STRATEGY FOR THE M&E FRAMEWORK CHAPTER 4 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 65 The implementation of the M&E framework will be spearheaded by the Ministry of Health – Division of Nutrition and Dietetics in collaboration with development partners and stakeholders at all levels. This will ensure successful implementation of M&E system in the Division of Nutrition and Dietetics. The implementation strategy shall be determined by the following: Human Resource development: 1) Availability of relevant human resource for Monitoring, Evaluation, Accountability and Learning. 2) Clearly defined roles of various stakeholders that indicate the information generators, information managers, information custodians and information users. 3) Highlighting and remedying of M&E capacity-gaps required across information generators, information managers, information custodians and information users in order for the M&E system to be efficient and functional. 4) Capacity building of relevant stakeholders to utilize nutrition data and information. Systems readiness for: 1) Appropriate information management infrastructure shall be in place to ensure compliance with data and information quality protocols, upwards and downwards flow of information and is easily accessible in an appropriate repository(ies). 2) Utilization of relevant emerging technologies that will accelerate information capture, aggregation, analysis and utilization. Pilot-tests of such technologies shall also provide learning experiences that shall be necessary for systems improvement. 3) Promotion of information quality management through frequent audits and checks. 4) Establishment of appropriate feedback and response mechanism with easy flow of information at different levels of nutrition programme implementation. 5) Forums for dissemination, learning and research. Funding Mechanisms that will boost M&E human resource and M&E systems Mechanisms should be put in place to ensure adequate funding for the NIS and M&E system activity cycle. The activity cycle includes data collection, transmission, aggregation, analysis and utilization. Such mechanisms include: 1) Integration of M&E activities and leveraging on resources for ongoing nutrition and nutrition-related programme activities for more efficient use of funds. 2) Use of and scale up of cost-effective strategies such as having online meetings, training and dissemination through teleconferencing instead of having physical meetings. 3) Mainstreaming nutrition information collection in other sector nonitoring and evaluation systems 4) Develop public/private partnerships to fund M&E system activities. Coordination mechanism 1) Clearly defined multi-sectoral coordination structure with partners and other stakeholders at national and county levels for the planning, implementation and dissemination of M&E activities. 2) Presence of platform/technical forum that coordinates the technical review, validation and provides mentorship and sharing of M&E feedback at national and county levels (See Table 24). 4.1 Roles and Responsibilities of Stakeholders The roles and responsibilities of stakeholders are shown in Table 24. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202266 Table 24: Roles and Responsibilities of stakeholders in the M&E Stakeholders M&E roles and responsibilities Division of Nutrition and Dietetics • Develop standards, guidelines and tools for monitoring and evaluation of nutrition projects and programmes in the country • Standardization of nutrition data collection methodologies, management, and reporting. • Overall management and implementation of Kenya Nutrition M&E framework. • Development of M&E implementation plan and operational manuals. • Provide technical support to counties in data collection, reporting and analysis including review and validation of data, methodologies and results. Build capacity of national and county levels on nutrition information and M&E. • Mobilize resources to support implementation of M&E plans and framework. • Conduct periodic data quality audits, develop data quality improvement plans and monitor their implementation. • In collaboration with KNBS, partners and stakeholders provide technical expertise in conducting various evaluations and surveys including Kenya National Micronutrient Survey (KNMS), Kenya Demographic Health Survey (KDHS), Kenya Integrated Household Budget Survey (KIHBS), Multiple Indicator Cluster Surveys (MICS). • Ensure effective coordination of nutrition M&E and information at national and county levels. • Coordinate national level nutrition surveys, programme evaluations and statistical modeling and facilitate dissemination of findings to counties and stakeholders. • Strengthen multi-sectoral linkages and partnerships e.g. mainstreaming nutrition M&E in the relevant sector information systems and technical working groups, joint monitoring and assessments, etc. • Keep a common (central) nutrition data repository and manage the Kenya Nutrition Website for improved data access and utilization. Develop and disseminate national level nutrition M&E and information products. • Monitor implementation of national and county annual work plans in consultation with county governments. • Coordinate mid-term and end-term review of the KNAP and support counties to monitor implementation of CNAPs. • Document and disseminate best practices, case studies, research findings and success stories for evidence-based programming. • Promote/support accountability and feedback mechanisms. Line Ministries/ Institution and Agencies including KNBS, KEMRI • Mainstream M&E for Nutrition in their M&E systems. • Monitor and report on nutrition indicators and activities that fall in their dockets. • Participate and provide technical inputs in development of Nutrition Sector M&E plans, guidelines and frameworks. • KNBS and KEMRI provide technical support and expertise for national level nutrition surveys. • Participate in mid-term and end-term review of the KNAP. • In collaboration with DND participate in joint monitoring and supervision of implementation of nutrition sensitive activities in KNAP. • Undertake resource mobilization for implementation of KNAP MEAL framework. Development Partners • Provide technical and financial support to ensure Nutrition Sector M&E system is functional. • Conduct/support advocacy and resource mobilization to support implementation of M&E plans and framework. • Provide technical support in development, dissemination and implementation of nutrition M&E framework, Plans and guidelines . • In collaboration with DND and KNBS participate and provide technical expertise in conducting various researches, evaluations and surveys Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 67 Stakeholders M&E roles and responsibilities County Health Management Team • Overall coordination of the implementation of nutrition M&E framework at the county level. • Ensure adherence to nutrition M&E standards and guidelines • Monitor implementation of county AWPs and develop annual performance reports. • Advocate for inclusion of nutrition indicators in county level plans such as the CIDP and CHSSP • Conduct mid-term and end-term review of the CNAPs • Domestication and dissemination of policies, guidelines, and reports. • Resource mobilization. • Provide technical and financial support for M&E activities. • Maintenance of the implementing partners’ database at the county level. • Manage the nutrition database at the county level. • Dissemination of all reports and M&E products developed at both the county and national level. • Conduct regular data quality audit activities in the county. • Conduct quarterly health stakeholders’ forum. • Operationalize the M&E TWG and CNTF. • Conduct data review at the county level. • Provide oversight on data collection and reporting. • Promote data demand and information use. • Conduct performance reviews at the county level. • Spearhead implementation of recommendations and improvement plans • Ensure proper information flow from various levels to inform decision-making. • Develop quarterly reports for the CECM, Chief Officer and County Director for Health. • Provide regular feedback on nutrition data quality to both sub counties and implementing partners. • Acquisition and distribution of HMIS tools to the sub counties. • Coordination of training, mentorship and OJTs. • Coordination of research and survey activities. • Development of quarterly and annual County Health Bulletin. • Provide technical, material and financial support for M&E to all sub-counties. • Carry out County M&E needs assessment and build capacity where applicable. • Keep a common (central) nutrition data repository at County level and update nutrition situation and reports in the relevant county websites. • With support from the national level, produce County specific tools for special studies and assessment based on need • Conduct Supportive supervision • Implementation of County feedback and accountability mechanism e.g. through community scorecards • Document and disseminate best practices, case studies, research findings and success stories for program adjustment and improvement Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202268 Stakeholders M&E roles and responsibilities Sub County Health Management Team • Coordinate and manage M&E at the Sub County level. • Mobilization of resources for Sub-County level planned activities. • Supervise nutrition data collection in the facilities. • Receive and compile nutrition data from health facilities, community units and implementing partners and feed all reports on performance tracking into the KHIS or any other e-data capturing system linked to the county in a timely manner. • Provide regular feedback to the health facilities and community units. • Utilize data generated at the Sub County level for decision making. • Ensure proper information flow from and to the health facilities and community health units in the Sub Counties. • Develop Sub-County Health report and share it with the CHMT and County Director for Health. • Disseminate quarterly reports to Sub-County health facilities and community units. • Aggregate, analyze, disseminate and use health and health-related data on the performance of the health sector priorities outlined in the CHSSIP from all community health units, health facilities and provide feedback to all. • Analyze the quality of all reports received from health facilities and community health units and ensure follow-up in case of incompleteness, problems with validity, and delays and provide technical support to all sub-county level operational units and all tiers of health facilities in the sub-county for M&E. • Conduct Routine data quality audit - RDQA (quarterly). • Conduct quarterly data review. • Conduct monthly data validation before entry into the KHIS. • Conduct oversight to manage all health and health-related data from all service providers within the sub-county. • Maintain and update a common data repository • Distribution and redistribution of HMIS tools to health facilities. • Coordination of training, mentorships, and on job trainings OJTs to health facilities and community units. • Coordinate research and survey activities. • Implementation of community feedback and accountability mechanism e.g. through community scorecards • Document and disseminate best practices, case studies, research findings and success stories Health facility • Maintain and update the Health Information System, including records, filing system(s) and registry for primary data collection tools (such as registers, cards, file folders), and summary forms (such as reporting forms, CDs, electronic backups). Data collection, compilation, analysis and on ward transmission to the sub counties. • Conduct monthly facility data review before submission to the Sub County level. • Safeguard data and information system from any risks e.g., termites, fire, floods, access by unauthorized persons etc. • Prepare an analysis of the data for discussion during staff and board meetings for decision-making. • Provide regular feedback to the Community Units (CUs). • Implementation of policies and guidelines. • Provide platforms for data dissemination, accountability and community feedback e.g. community scorecards, community dialogues, suggestion boxes etc. • Document and share best practices, case studies, research findings and success stories Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 69 Stakeholders M&E roles and responsibilities Community Unit • Collect data from the community. • Participate in community surveillance activities e.g. reporting of increased cases of children with malnutrition • Community involvement and consultation in nutrition data and information processes • Update and maintain community health information within the KHIS. • Compile and submit monthly reports to the health facility. • Conduct dialogue and action days. • Receive feedback from the facility, Sub County and County levels. • Use information collected and feedback received for decision making. • Develop quarterly and annual community health and nutrition reports for integration into facility reports. • Carry out M&E and regularly update household members in forums such as community dialogue days. • Maintain registers for documentation of household visits, activities and report regularly to supervising link-health facility. • Share best practices and success stories for documentation and scale up 4.2 Technical Coordination Mechanisms The M&E technical coordination will align with Monitoring and Evaluation Framework of the Ministry of Health at the National and County levels. The technical M&E coordination structures will include Nutrition Information Technical Working Group (NITWG) and Research Technical Working Groups at the national level. The roles of these structures are outlined below. 4.2.1 Nutrition Information Technical Working Group Nutrition Information Technical Working Group at the national level will play the following roles: • Develop standards and guidelines for nutrition information. • Contextualize relevant international guidelines for Kenya. • Review and validate nutrition information collection, analysis and reporting. • Centralize nutrition information, disseminate and advocate for action. • Capacity strengthening/offer technical support on nutrition information when and as needed especially to the counties. • Produce Nutrition Situation Reports. • Strengthen multi-sectoral linkages on nutrition information through direct participation at various forums (education, social protection, agriculture, livestock, special programmes etc) • Promote knowledge management among members of NITWG. • Promote documentation of success stories/lessons by stakeholders. • Strengthen continuity of NITWG partnership with stakeholders such as NDMA, KNBS, FEWSNET, MoH HIS and enhance linkages with other working groups within the sector. • Establish linkage with and support county level M&E committees: o Build M&E capacity at the county. o Support the operationalization of M&E framework by guiding the development of county M&E Plans. 4.2.2 Research in Nutrition Technical Working Group (RNTWG) Research in Nutrition Technical Working Group will play the following roles: • Coordinate research in nutrition. • Provide expert advice, technical guidance and leadership in nutrition research including networking. • Identify priority areas for nutrition research in the country. • Dissemination and sharing of research findings • Support/advocate for uptake of research findings. • Resource mobilization for priority research in nutrition. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202270 • Establish a nutrition research repository database and create an access platform available to the public. • Knowledge management. • Coordination and linkage through setting up a community of practice by linking research finding to policy implementation. • Promote nutrition research covering all areas in the field of nutrition. 4.3 Capacity Development for Nutrition Information and M&E In order to improve system wide capacity in nutrition M&E, the four thematic areas (systemic, organizational, technical and community capacity) stipulated in the Kenya Nutrition Capacity Development Framework will guide capacity development for nutrition information and M&E. The following shall apply under this framework: 1. Nutrition M&E focal person is responsible for all aspects of capacity development in M&E and NIS including; systemic, organizational, technical and community capacity developments NIS/M&E initiatives. 2. Collection, analysis, validation and dissemination of capacity development assessment data on systemic, organizational, technical and community capacities for sound decision making on service delivery. 3. Capacity strengthening in nutrition M&E for all cadres of service delivery. 4. Link M&E systems to nutrition specific and nutrition sensitive sectors (e.g. agriculture, education, social protection, among others) to ensure adequate multi-sectorial data is available and used for decision making. 5. Monitor improved communication and linkages between regulatory organizations and partners. 4.3.1 Systemic capacity for M and E There are several laws, guidelines and policies developed within the nutrition specific and nutrition sensitive programmes. For nutrition M&E component to be successfully implemented, this framework recommends: • The nutrition workforce capacity to understand and implement these policies, laws, regulations and standards should be enhanced. • The knowledge and understanding of policies among county government and other implementers should be promoted to increase the impact, coverage and monitoring of activities herein. • Efforts should be made to ensure that county level governments allocate resources for NIS and M&E. • The M&E guidelines will be disseminated at the national, county level and at stakeholder forums using innovative and non-resource intensive platforms. • The implementers shall be equipped with resource mobilization, planning and budgeting skills, without which, efforts to successfully monitor nutrition activities will be undermined and frustrated. 4.3.2 Organizational capacity The competencies required by nutrition professionals at organizational level and the areas of focus required for improved organizational capacity are key for successful monitoring and evaluation. Organizational capacity development should include the need for well-established infrastructure, tools and equipment in addition to skills enhancement. For instance, the skills for nutrition assessment can be compromised with the absence of relevant anthropometry equipment thereby negatively affecting the success of M&E activities. To ensure successful M&E competencies of implementers to coordinate M&E operations, staff and resources, as well as supervisory services, will need to be enhanced. In addition, technical oversight and capacity development for coordination within government line Ministries, NGOs, private sector, regulatory bodies and UN systems and other stakeholders addressing the various nutrition interventions will be required. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 71 Nutrition issues of non-technical nature such as those related to the implementation process lack a visible database such as the KHIS. This means attaining information for programming or process related indicators require an un-systemized approach between individuals at national level and sub-national levels. Therefore, verifiable indicators such as: programme documents, working group coordination minutes and other relevant reports depicting activities undertaken will serve as verification. Qualitative and quantitative assessments and evaluations conducted by NGOs or other project-based activities will also depict capacity development issues in M&E and progress made. Other key capacities within the organizational pillar include: data collection and recording; how to use this data for decision making and advocacy, developing suitable indicators and capacity to conduct high quality research and utilization of the results for learning purposes. 4.3.3 Technical capacity This refers to both the adequacy of workforce for M&E activities in all areas and also the proficiency in knowledge and skills necessary for effective M&E and NIS implementation. Human resources for NIS and nutrition M&E is one of the aspects where there is need for improvement. The findings from M&E system review17 indicated 64.7 percent of the respondents reported that the human capacity is low, 29.5 percent indicated that it was moderate and only 5.9 percent said that it was high. To a large extent high staff turnover contributes to the inadequacy in capacity as this implies continuous training is necessary to build capacity of the new staff. At the national level, human capacity for M&E particularly at the DND and HIV and Nutrition, and TB programmes was relatively good but inadequate at the NCD programme. Most counties have employed nutritionists since devolution with disparity across counties. Likewise, capacity has improved with varying levels of intensity at the sub-county level; for many sub-counties the capacity is inadequate. Technical staff in the government and in partner organizations, both at national and county levels have contributed significantly to overall system strengthening. Knowledge and skills for M&E varies across the data sources. For the population-based surveys (Integrated SMART surveys, MIYCN KABP, coverage, etc) the capacity to conduct these surveys is considered adequate because of the intense level of training received by those involved. Most of these surveys are funded by partners and therefore there are frequent trainings of personnel to conduct the frequently conducted surveys. However, only select highly vulnerable counties are covered and the system is heavily reliant on external funding therefore in the absence of this the system capacity would be negatively affected. For the routine data; human capacity is an issue influencing the M&E implementation, timely data collection and comprehensive reporting and quality of data right from the collection point. Funding is a major constraint limiting capacity development for M&E. Some of the inadequacies in capacity could be addressed through technical supervision, but again these are hampered by inadequate funding. More sustainable capacity development initiatives need to be further scaled up such as: on job training; mentorship programmes; and continuous professional development. A lot of effort has been geared towards capacity development for nutrition-specific interventions; capacity for nutrition-sensitive actions will require increased attention. The M&E review findings also reported that efforts are in place to identify and utilize alternative strategies for capacity building. For example, it was reported that the Coordination Sector at the national level have conducted some capacity building for counties by teleconference. This was reported to be feasible and a cost-effective way of training because funds for per-diems is not required. The strategy has not had the same level of success at the sub-county level. Nutrition in HIV and Nutrition in TB programmes are also using this strategy for the training and dissemination of data. Nonetheless, full utilization of this strategy will depend on the change of people’s mind-set, availability of computers and internet connectivity. Since proficiencies and competencies attained by nutrition workforce through formal training is more sustainable, this framework suggests linkage with training institutions as follows: • DND participation in curriculum reviews to ensure M&E for nutrition is informed by practice. • Incorporation of trainers from learning institutions in review of guidelines, dissemination and roll out of M&E programmes where possible. 17 NIS/M&E system review report December 2019 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202272 4.3.4 Community capacity Communities shall utilize data from Nutrition M&E to ensure the following: 1) Increased community awareness that results in demand for nutrition services through increased linkage with diverse community engagement strategies: (e.g. Community Strategy, of the Ministry of Health, School Health Programmes of the Ministry of Education and Junior Farmer Field and Life School (JFFLS) of the Ministry of Agriculture). In addition, the increased nutrition awareness will also result in better community participation practices that positively influence the overall service delivery at community level. When communities are aware of the nutrition services that they ought to receive, they will prompt the health facilities and local health authorities at national and sub-national levels to capacitate health staff and link them with community systems to provide required services. 2) A vibrant community linkage to the health system network evidenced by; increased service uptake, cohesive links between community and health systems and nutrition service delivery that is responsive to community needs. 3) Increased Nutrition Sector visibility through the use of champions who utilize data and evidence from MEAL to advocate for inclusion of nutrition into county government policies. 4.4 Data Quality Assurance The data quality assurance (DQA) process will strive to ensure nutrition data is accurate, precise, reliable, timely, relevant and complete. DQA shall be conducted in data generation points, sub county level and county levels on a quarterly basis with support from national level. Tools and programmes for documenting DQA results will be used to ensure regular targeted support supervision for technical support at different levels. This shall be done to safeguard the minimum acceptable standards and ensure data produced is reliable and valid for decision making. Routine Data Quality Audits (RDQA) tools will be used to verify the quality of reported data on key indicators.18. RDQA tools shall be used to conduct routine data quality checks as part of the on-going supervision, initial and follow up assessment of the data management and reporting systems, strengthening programmes staff capacity on data management and reporting as well as conducting formal data quality audits. Areas that will be considered for audit include the following: o Reviewing availability, completeness and accuracy of all indicator source documents for the selected reporting period. o Recounting results from source document and comparing the verified numbers to the site reported numbers and explaining discrepancies if any. o Cross-checking reported results with other data sources, for example comparing routine data with survey data. o Nutrition indicators definitions and reporting guidelines. o Availability of nutrition data-collection and reporting forms and tools. o Data management processes such as back up and confidentiality of source documents and registers. o M&E system Structure, Functions and Capabilities. o Compliance of reporting through the National Reporting System (KHIS). As part of data quality audit, NITWG and Nutrition Programme teams shall conduct data clinics as well as conduct review and validation of methodology, tools and findings of all surveys and assessments in nutrition sector to inform planning and decision making for interventions. 18 https://www.measureevaluation.org/resources/publications/ms-17-117 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 73 4.5 Funding of the M&E system The funding for the M&E system shall respond to the multi-sector Kenya National Nutrition Action Plan 2018 2022 and shall be advocated for and be sourced from various ministries namely; health, livestock, fisheries, water and agriculture. The key oversight ministry shall be the Ministry of Health. This model will similarly be adopted at the county level departments based on their local multi-sectoral relationships. Partnerships with Non-Governmental Organizations (NGOs) and business entities involved in support of the nutrition specific or nutrition sensitive actions will complement the funding for the system. Business entities including but not limited to those involved in food fortification shall be approached to invest in market surveys and compliance monitoring within the production industry. According to the M&E system review, 65.6 percent of the respondents stated that funding for M&E activities is poor while one-third (31.3 percent) stated that it was moderate. The appropriate response to this would be to target investment and financial accountability for M&E activities that align to the nutrition activity investments for nutrition sensitive and specific activities. To ensure successful monitoring and evaluation of activities, 5 to 10% of the total DND nutrition activity budgets, County departments budgets and partners’ project budget with relevant nutrition activities should be allocated to the multi-sector monitoring and evaluation activities. This does not include funds allocated for human resource. National, county and partner funding commitments should demonstrate both allocation and disbursement of their funding quota as part of the sustainability model for the M&E system. The funds generated will be used for production of data collection tools, M&E trainings, upgrade/maintenance of computer hardware and related networks, development/maintenance costs of software for nutrition database, costs related to data collection, cleaning and transmission, data analysis and meta-analysis, information dissemination, accountability and learning forums, communication and supportive supervision to give on-the-job technical assistance. To ensure implementation of this requirement, a clause on this condition will be included in any agreement that the division signs with its partners with both parties demonstrating to co-share in allocation and eventual disbursement. The DND programmes will also take part in funds mobilization while taking advantage of the existing periodic surveys and systems e.g. MICS, KHIBS, DHS, Health facility Assessment survey to include specific programmes indicators as defined through the M&E framework. 4.5.1 Advocacy for nutrition information and M&E Advocacy and resource mobilization for nutrition information and M&E shall be enhanced through the following: 1) Nutrition activities shall constantly require increased activity funding allocations. To demonstrate the funding gaps, information generated from county and national public accounts will be synthesized and shared as a point of advocacy to mobilize for more support from the County and National government funding mechanisms. 2) In order to increase the prominence of the NIS/M&E system, there will be need to constantly advocate for increased funding to MEAL activities as stipulated in the M&E framework to cover the M&E activity gaps. The agencies who are custodians of operationalization of the NIS/M&E Framework should build confidence of prospective funders/donors by increasing the level of accountability around how much was allocated/available and how much has been spent and what is the cost-benefit of the investment. 3) Advocacy efforts for funding of M&E/NIS activities must also include financial joint planning that limits duplication of funding efforts within the defined multi-sector context. This will broaden the base of funding opportunities for NIS/M&E activities. 4.5.2 Costing The KNAP M&E implementation framework will cost a total of Ksh1, 014,110,000 shown in Table 25. Annex 7 presents detailed financial resource requirement by year. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202274 Table 25: Cost of the M&E framework Implementation (figures captured are in millions) Aspect/Year 1 2 3 4 5 Total Monitoring Ksh.32.86 Ksh. 30.01 Ksh 39.18 Ksh 30.35 Ksh 85.15 Ksh.217.55 Evaluation Ksh 60.15 Ksh 60.15 Ksh. 165.15 Ksh. 60.15 Ksh. 60.15 Ksh.405.75 Accountability X X X X X X Learning Ksh.30.74 Ksh. 22.25 Ksh.28.97 Ksh. 26.11 Ksh. 25.87 Ksh.133.94 Capacity development Ksh.31.37 Ksh. 83.33 Ksh. 36.99 Ksh. 36.58 Ksh. 68.6 Ksh.256.87 Total (in millions) Ksh.155.12 Ksh.195.74 Ksh.270.29 Ksh.153.19 Ksh.239.77 Ksh.1,014.11 4.6 Accountability: Feedback and Response mechanisms An effective feedback and response mechanism is critical for successful implementation of nutrition programmes. It promotes accountability in the programme by providing means to identify and respond to information requests, suggestions and complaints. Different channels will be used for giving feedback, complaints and response - these channels will include; community meetings and dialogues, community scorecards, suggestion boxes, hotlines, SMS platforms, monitoring visits focused on stakeholders’ feedback, designated feedback days for the local office/ facilities to receive feedback as well as through emails. Feedback will be provided at various levels of coordination and implementation to improve delivery of nutrition services. The processes for providing the feedback will be as follows: 1) Counties will provide feedback to implementers and service delivery points during support supervision and review visits. These visits will be informed by feedback issues identified in the reports. 2) Counties and sub-counties will interrogate the performance of nutrition indicators and provide feedback on the progress. 3) At the national and county levels, there will be regular generation of data on critical issues to be addressed. At the national and county levels NTF and CNTF respectively, a task force will be formed that regularly receives and relays information to the stakeholders. This will enable the teams to be accountable at every level. 4.7 Updating of the Framework The life of this framework is 5 years, in line with the KNAP 2018-2022. Regular update of the M&E plan will be done based on modification and/or inclusion of new interventions into the Division of Nutrition and Dietetics. M&E plan will be revised if new interventions to achieve any of the programme specific objectives are introduced based on the Kenya Nutrition Action Plan. A mid-term review of the framework will be done in 2020 to measure progress of its implementation and make necessary amendments. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 75 BIBLIOGRAPHY 12 Components Monitoring and Evaluation System Strengthening Tool. Geneva: UNAIDS, 2009a County Government of Homa Bay, (2018). Department of Health Services. 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Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202276 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 77 Annexes Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202278 In di ca to rs Ve ry L ow Lo w M ed iu m H ig h Ve ry H ig h W as tin g <2 .5 % 2. 5% < 5% 5% to < 10 % 10 % to < 15 % ≥ 15 % O ve rw ei gh t <2 .5 % 2. 5% < 5% 5% to < 10 % 10 % to < 15 % ≥ 15 % St un tin g <2 .5 % 2. 5% < 10 % 10 % to < 20 % 20 % to < 30 % ≥ 30 % In di ca to rs A cc ep ta bl e A le rt Se ri ou s Cr it ic al Ve ry c ri ti ca l M ea n w ei gh t f or h ei gh t ( W H Z) > 0. 04 0 .4 0 to 0 .6 9 0 .7 0 to 0 .9 9; >u su al / in cr ea si ng < 1. 00 ; > us ua l / in cr ea si ng GA M b y M UA C ch ild re n (% <1 2. 5) < 5 % <5 % w it h in cr ea se fr om se as on al tr en ds 5. 0 9 .9 % 10 .0 – 14 .9 % , o r w he re th er e is si gn ifi ca nt in cr ea se fr om se as on al tr en ds >1 5% , o r w he re th er e i s sig ni fic an t i nc re as e fr om se as on al tr en ds A du lt M U A C – Pr eg na nt an d La ct at in g ( % <2 3. 0c m , s ph er e 04 ) <9 .5 % 9. 5% 14 .9 % 1 5 – 2 1 .9 % 22 .0 – 2 7. 9% ≥2 8% A du lt M U A C – N on P re gn an t a nd N on La ct at in g (% <1 8. 5c m , s ph er e 04 ) <0 .3 % 0. 3 0 .4 9% 0. 5 0 .6 9% 0. 7 – 1. 99 % ≥2 .0 % In di ca to rs L o w M ed iu m H ig h P re va le n ce V er y H ig h p re va le n ce Ad ul t B M I< 18 .5 < 1 0 % 10 .0 to 1 9. 9% 20 .0 to 3 9. 9% > 4 0 % In di ca to r N o P u b li c h ea lt h p ro b le m M ild p ub lic he al th p ro bl em M od er at e pu bl ic he al th p ro bl em Se ve re p u b li c h ea lt h p ro b le m An em ia 19 <1 10 g /l a t s ea le ve l < 4 .9 5. 0 19 .9 20 .0 3 9. 9 ≥ 4 0 .0 Po or H H d ie ta ry D iv er si ty (% co ns um in g <4 fd gp s) ) < 5 % 5 9. 9% 10 2 4. 9% 25 4 9. 9% ≥ 50 % Br ea st fe ed in g pr ac tic es : ( i)E BF , ( ii) C on tin ue d BF a t 1 yr . (ii i)C on tin ue d BF a t 2 yr . r ef er en ce ≥9 0% 50 8 9% 12 4 9% 0 11 % Vi ta m in A su pp le m en ta tio n co ve ra ge : 1 do se in la st 6 m on th s ≥9 5% 80 9 4. 9% < 8 0 % Cr ud e de at h ra te /1 00 00 /d ay <0 .5 0. 5 to < 1 1 to < 2 in cl ud e in fo rm at io n on th e m ai n ca us es 2 t o ≤ 5 i nc lu de in fo rm at io n on th e m an ca us es >5 o r d ou bl in g of ra te fr om pr ec ed in g p ha se . In clu de m ai n ca us es Un de r f iv e y ea rs de at h ra te s/ 10 00 0/ da y <1 1 1. 99 2 3. 9/ 10 00 0/ da y i nc lu de m ai n ca us e 4 to 9 .9 o r do ub lin g fr om pr ev io us p ha se , in clu de m ai n ca us e ≥1 0 or d ou bl in g ra te fr om pr ec ed in g p ha se . In clu de m ai n ca us e A n n ex 1 : N ut ri ti on in di ca to rs th re sh ol ds 19 W H O ( 20 10 ). N ut ri ti on L an ds ca pe In fo rm at io n Sy st em ( N LI S) c ou nt y pr of ile in di ca to rs . G en ev a. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 79 A n n ex 2 I n di ca to r Co m pe n di um A n n ex 2 .1 A n th ro po m et ri c m ea su re m en ts In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pe rc en ta ge o f c hi ld re n le ss th an fi ve ( < 5) ye ar s w ho a re s tu nt ed St un ti ng H ei gh t f or a ge < 2 z sc or e N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us tw o st an da rd de vi at io ns fr om th e m ed ia n he ig ht f or a ge o f t he W H O Ch ild G ro w th S ta nd ar ds To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s Pe ri od ic al ly ( ev er y 2 5 ye ar s) In te gr at ed S M A RT su rv ey s pr ov id e da ta fo r ch ild re n 6 to 5 9 m on th s D is ag gr eg at io n: A ge , S ex , L oc at io n (u rb an /r ur al ), B ou nd ar ie s Pe rc en ta ge o f c hi ld re n le ss th an fi ve ( < 5) ye ar s w ho a re s ev er el y st un te d Se ve re st un ti ng H ei gh t f or a ge < 3 z s co re N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us th re e st an da rd de vi at io ns fr om th e m ed ia n he ig ht f or a ge o f t he W H O Ch ild G ro w th S ta nd ar ds To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s Pe ri od ic al ly ( ev er y 2 5 ye ar s) In te gr at ed S M A RT su rv ey s pr ov id e da ta fo r ch ild re n 6 to 5 9 m on th s Pe rc en ta ge o f c hi ld re n un de r th e ag e of fi ve ye ar s, w ho a re w as te d (a cu te m al nu tr it io n) . W ei gh t f or h ei gh t Z sc or e W as ti ng / ac ut e m al nu tr it io n (< 2 z s co re an d/ or oe de m a) N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us tw o st an da rd de vi at io ns fr om th e m ed ia n w ei gh t f or h ei gh t of th e W H O C hi ld G ro w th St an da rd s To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed su rv ey s. K D H S, S M A RT s ur ve ys Pe ri od ic al ly ( ev er y 2 5 ye ar s) Co nd uc te d an nu al o r se m i an nu al ly in a re as th at a re p ro ne to s ho ck s Fr eq ue nc y sh ou ld be in cr ea se d du ri ng sh oc ks o r em er ge nc ie s fo r ea rl y de te ct io n of de te ri or at in g si tu at io n an d to in fo rm r es po ns e Pe rc en ta ge o f c hi ld re n un de r th e ag e of fi ve ye ar s, w ho a re s ev er el y w as te d/ se ve re a cu te m al nu tr it io n W ei gh t f or h ei gh t Z sc or e W as ti ng (< 3 z s co re an d/ or oe de m a) N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us th re e st an da rd de vi at io ns fr om th e m ed ia n w ei gh t f or h ei gh t of th e W H O C hi ld G ro w th St an da rd s an d/ or o ed em a To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed su rv ey s. K D H S, S M A RT s ur ve ys Pe ri od ic al ly ( ev er y 2 5 ye ar s Co nd uc te d an nu al o r se m i an nu al ly in a re as th at a re p ro ne to s ho ck s Pr ev al en ce o f A cu te M al nu tr it io n by M U A C G A M b y M U A C N um be r of c hi ld re n ag ed 0 59 m on th s w it h M U A C < 12 5 m m a nd /o r oe de m a) To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s: SM A RT s ur ve ys , N D M A E ar ly w ar ni ng sy st em , m as s sc re en in g, M IY CN E ra pi d as se ss m en ts Pe ri od ic al ly ( ev er y 2 5 ye ar s Co nd uc te d an nu al ly o r se m i an nu al ly in a re as th at a re p ro ne to s ho ck s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202280 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr ev al en ce o f se ve re a cu te m al nu tr it io n by M U A C SA M b y M U A C N um be r of c hi ld re n ag ed 0 59 m on th s w it h M U A C < 11 5 m m a nd /o r oe de m a) To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s: SM A RT s ur ve ys , N D M A E ar ly w ar ni ng sy st em , m as s sc re en in g, M IY CN E ra pi d as se ss m en ts Pe ri od ic al ly ( ev er y 2 5 ye ar s Co nd uc te d an nu al o r se m i an nu al ly in a re as th at a re p ro ne to s ho ck s Pr ev al en ce o f un de rw ei gh t (< 2 z s co re ) U nd er w ei gh t W ei gh t f or ag e < 2 z sc or e N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us tw o st an da rd de vi at io ns fr om th e m ed ia n w ei gh t fo r ag e of th e W H O Ch ild G ro w th S ta nd ar ds To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s Pe ri od ic al ly ( ev er y 2 5 ye ar s Pr ev al en ce o f s ev er e un de rw ei gh t (< 3 z s co re ) Se ve re un de rw ei gh t W ei gh t f or ag e < 3 z sc or e N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us th re e st an da rd de vi at io ns fr om th e m ed ia n w ei gh t fo r ag e of th e W H O Ch ild G ro w th S ta nd ar ds To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s Pe ri od ic al ly ( ev er y 2 5 ye ar s Pe rc en ta ge o f u nd er fiv e Ch ild re n at te nd in g CW C w ho a re u nd er W ei gh t R ou ti ne m ea su re m en t an d th e ch ild w el fa re c lin ic N um be r of c hi ld re n un de r th e ag e of 5 y ea rs a tt en di ng CW C w it h w ei gh t f or a ge b el ow 2 S D To ta l n um be r of c hi ld re n un de r 5 ye ar s w ei gh ed a t t he CW C Pe rc en ta ge K H IS a gg re ga te ( K H IS ) M on th ly H ea lt h fa ci lit y da ta – m ay n ot b e re pr es en ta tiv e of th e ta rg et p op ul at io n as on ly a p ro po rt io n of th e po pu la ti on m ay be a tt en di ng C W C es pe ci al ly a m on g ch ild re n ab ov e on e ye ar Pe rc en ta ge o f c hi ld re n un de r 5 ye ar s w ho a re at te nd in g M CH fo r gr ow th m on it or in g fo r th e fir st ti m e. G ro w th m on it or in g an d pr om ot io n N um be r of C hi ld re n un de r 5 ye ar s w ho a re a tt en di ng M CH fo r gr ow th m on it or in g fo r th e fir st ti m e To ta l n um be r of c hi ld re n un de r fiv e ye ar s ol d in th e ca tc hm en t a re a Pe rc en ta ge K H IS a gg re ga te M on th ly Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 81 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on o f c hi ld re n 6 59 m on th s w it h m od er at e ac ut e m al nu tr it io n (M A M ) re ce iv in g tr ea tm en t M A M in di re ct co ve ra ge N o. o f n ew M A M c as es w ho r ec ei ve d tr ea tm en t (o ut pa ti en t o r in p at ie nt ca re ) in th e m on th pr ec ed in g N o. o f M A M ca se s in ca tc hm en t a re a Pe rc en ta ge N um er at or fr om ro ut in e da ta – K H IS ag gr eg at e D en om in at or : se as on al a ss es sm en ts c as el oa d ca lc ul at io n te m pl at e M on th ly R ec om m en de d no t t o ca lc ul at e a pe rc en ta ge pe r H F bu t r at he r tr ac k ad m is si on s tr en ds ; ca lc ul at in g co ve ra ge is be tt er d on e at h ig he r le ve l. R aw a dm is si on s tr en ds c an b e us ed fo r su rv ei lla nc e; if ad m is si on s tr en ds v ar y fr om p re vi ou s ye ar s, th is c an b e po te nt ia lly us ed to in te rp re t th e se ve ri ty o f a cu te m al nu tr it io n si tu at io n in th at a re a. Pr op or ti on o f ch ild re n 6 59 m on th s w it h m od er at e ac ut e m al nu tr it io n di sc ha rg ed a s: a ) Cu re d, b ) D ie d, c ) D ef au lt ed M A M pr og ra m m es tr ea tm en t ou tc om es : cu re d de fa ul te d, di sc ha rg ed N um be r of c hi ld re n 6 59 m on th s w it h m od er at e ac ut e m al nu tr it io n di sc ha rg ed a s: a ) Cu re d, b ) D ie d, c ) D ef au lt ed N um be r of ch ild re n 6 59 m on th s w it h m od er at e ac ut e m al nu tr it io n di sc ha rg ed fr om tr ea tm en t Pe rc en ta ge K H IS a gg re ga te In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr ev al en ce o f se ve re a cu te m al nu tr it io n by M U A C SA M b y M U A C N um be r of c hi ld re n ag ed 0 59 m on th s w it h M U A C < 11 5 m m a nd /o r oe de m a) To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d. Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s: SM A RT s ur ve ys , N D M A E ar ly w ar ni ng sy st em , m as s sc re en in g, M IY CN E ra pi d as se ss m en ts Pe ri od ic al ly ( ev er y 2 5 ye ar s Co nd uc te d an nu al o r se m i an nu al ly in a re as th at a re p ro ne to s ho ck s Pr ev al en ce o f un de rw ei gh t (< 2 z s co re ) U nd er w ei gh t W ei gh t f or ag e < 2 z sc or e N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us tw o st an da rd de vi at io ns fr om th e m ed ia n w ei gh t fo r ag e of th e W H O Ch ild G ro w th S ta nd ar ds To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s Pe ri od ic al ly ( ev er y 2 5 ye ar s Pr ev al en ce o f s ev er e un de rw ei gh t (< 3 z s co re ) Se ve re un de rw ei gh t W ei gh t f or ag e < 3 z sc or e N um be r of c hi ld re n ag ed 0 59 m on th s th at fa ll be lo w m in us th re e st an da rd de vi at io ns fr om th e m ed ia n w ei gh t fo r ag e of th e W H O Ch ild G ro w th S ta nd ar ds To ta l n um be r of c hi ld re n 0 59 m on th s w ho a re m ea su re d Pe rc en ta ge Po pu la ti on b as ed ho us eh ol d su rv ey s Pe ri od ic al ly ( ev er y 2 5 ye ar s Pe rc en ta ge o f u nd er fiv e Ch ild re n at te nd in g CW C w ho a re u nd er W ei gh t R ou ti ne m ea su re m en t an d th e ch ild w el fa re c lin ic N um be r of c hi ld re n un de r th e ag e of 5 y ea rs a tt en di ng CW C w it h w ei gh t f or a ge b el ow 2 S D To ta l n um be r of c hi ld re n un de r 5 ye ar s w ei gh ed a t t he CW C Pe rc en ta ge K H IS a gg re ga te ( K H IS ) M on th ly H ea lt h fa ci lit y da ta – m ay n ot b e re pr es en ta tiv e of th e ta rg et p op ul at io n as on ly a p ro po rt io n of th e po pu la ti on m ay be a tt en di ng C W C es pe ci al ly a m on g ch ild re n ab ov e on e ye ar Pe rc en ta ge o f c hi ld re n un de r 5 ye ar s w ho a re at te nd in g M CH fo r gr ow th m on it or in g fo r th e fir st ti m e. G ro w th m on it or in g an d pr om ot io n N um be r of C hi ld re n un de r 5 ye ar s w ho a re a tt en di ng M CH fo r gr ow th m on it or in g fo r th e fir st ti m e To ta l n um be r of c hi ld re n un de r fiv e ye ar s ol d in th e ca tc hm en t a re a Pe rc en ta ge K H IS a gg re ga te M on th ly Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202282 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on o f ch ild re n 6 59 m on th s w it h se ve re a cu te m al nu tr it io n re ce iv in g tr ea tm en t SA M in di re ct co ve ra ge N o. o f n ew S A M c as es w ho r ec ei ve d tr ea tm en t (o ut pa ti en t o r in p at ie nt ca re ) in th e m on th pr ec ed in g N o. o f S A M ca se s in ca tc hm en t a re a Pe rc en ta ge N um er at or fr om ro ut in e da ta – K H IS ag gr eg at e D en om in at or : se as on al a ss es sm en ts c as el oa d ca lc ul at io n te m pl at e R ec om m en de d no t t o ca lc ul at e a pe rc en ta ge pe r H F bu t r at he r tr ac k ad m is si on s tr en ds ; ca lc ul at in g co ve ra ge is be tt er d on e at h ig he r le ve l. R aw a dm is si on s tr en ds c an b e us ed fo r su rv ei lla nc e; if ad m is si on s tr en ds v ar y fr om p re vi ou s ye ar s, th is c an b e po te nt ia lly us ed to in te rp re t th e se ve ri ty o f a cu te m al nu tr it io n si tu at io n in th at a re a. Pr op or ti on o f ch ild re n 6 59 m on th s w it h se ve re ac ut e m al nu tr it io n di sc ha rg ed a s: a ) Cu re d, b ) D ie d, c ) D ef au lt ed SA M p ro gr am m es tr ea tm en t ou tc om es : c ur ed d ef au lt ed , di sc ha rg ed N um be r of ch ild re n 6 59 m on th s w it h se ve re a cu te m al nu tr it io n di sc ha rg ed as : a ) Cu re d, b) D ie d, c ) D ef au lt ed N um be r of ch ild re n 6 59 m on th s w it h se ve re a cu te m al nu tr it io n di sc ha rg ed fr om tr ea tm en t (e xc l. tr an sf er s) K H IS a gg re ga te Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 83 A n n ex 2 .2 In di ca to rs to a ss es s fo r M N P s pr og ra m m es c ov er ag e in p op ul at io n b as ed s ur ve ys In di ca to rs to a ss es s M N Ps p ro gr am m es p er fo rm an ce a nd c ov er ag e sh ou ld c ov er th e fo llo w in g co m po ne nt s: c om m od it y av ai la bi lit y, h um an re so ur ce , ge og ra ph ic c ov er ag e, u ti liz at io n an d co m m un it y ca pa ci ty to d em an d fo r M N Ps s er vi ce s. M N P C ov er ag e In di ca to rs In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g In te rp re ta ti on Co m m od it ie s av ai la bi li ty Pr op or ti on o f h ea lt h fa ci lit ie s th at d o no t h av e M N Ps S to ck s H ea lt h fa ci lit ie s w it ho ut M N Ps s to ck s N um be r of h ea lt h fa ci lit ie s w it ho ut M N Ps s to ck s N um be r of H ea lt h fa ci lit ie s in th e Co un ty Pe rc en ta ge M oH 7 34 (L M IS R ep or t) M on th ly H um an R es ou rc e Pr op or ti on o f h ea lt h w or ke rs pr ov id in g M N Ps s er vi ce s H ea lt h w or ke rs of fe ri ng th e M N Ps se rv ic es N um be r of h ea lt h w or ke rs p ro vi di ng M N Ps s er vi ce s To ta l n um be r of h ea lt h w or ke rs s am pl ed / in te rv ie w ed Pe rc en ta ge K A P su rv ey Ev er y 2 ye ar s Pr op or ti on o f h ea lt h w or ke rs pr ov id in g M N Ps w ho h av e be en tr ai ne d on M N Ps gu id el in es H ea lt h w or ke rs pr ov id in g M N Ps se rv ic es tr ai ne d on th e gu id el in es N um be r of h ea lt h w or ke rs p ro vi di ng M N Ps s er vi ce s w ho ha ve b ee n tr ai ne d on th e M N Ps g ui de lin es To ta l N um be r of h ea lt h w or ke rs in th e Co un tr y/ Co un ty /S am pl ed Pe rc en ta ge Ca pa ci ty as se ss m en t re po rt s Ev er y 2 ye ar s G eo gr ap hi ca l c ov er ag e Pr op or ti on o f h ea lt h fa ci lit ie s of fe ri ng M N Ps s er vi ce s H ea lt h fa ci lit ie s of fe ri ng M N PS se rv ic es N um be r of h ea lt h fa ci lit ie s of fe ri ng M N PS s er vi ce s To ta l n um be r of h ea lt h fa ci lit ie s in a C ou nt y/ R eg io n sa m pl ed Pe rc en ta ge LQ A S A d ho c as se ss m en ts Ev er y 2 ye ar s H ea lt h fa ci lit ie s of fe ri ng M N PS sh ou ld b e eq ua lly di st ri bu te d to e ns ur e as m an y ch ild re n as p os si bl e ar e re ac he d Pr op or ti on o f h ea lt h fa ci lit ie s w it h M N Ps p ol ic y an d IE C m at er ia ls H ea lt h fa ci lit ie s w it h M N Ps p ol ic y an d IE C m at er ia ls N um be r of h ea lt h fa ci lit ie s w it h M N Ps po lic y a nd IE C m at er ia ls To ta l n um be r of h ea lt h fa ci lit ie s in th e co un tr y/ re gi on o r sa m pl ed in a su rv ey Pe rc en ta ge SM A RT su rv ey s K A P su rv ey LQ A S A nn ua lly Ev er y 2 ye ar s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202284 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g In te rp re ta ti on U ti li za ti on Pr op or ti on o f C hi ld re n 6 to 23 m on th s en ro lle d in M N Ps pr og ra m m es Ch ild re n 6 to 2 3 m on th s w ho r ec ei ve M N Ps fr om h ea lt h fa ci lit ie s N um be r of c hi ld re n 6 to 2 3 m on th s en ro lle d in M N Ps Pr og ra m m es To ta l n um be r of c hi ld re n 6 to 2 3 in th e ca tc hm en t ar ea o r sa m pl ed in c as e of su rv ey s Pe rc en ta ge M oH 7 11 SM A RT Su rv ey s K A P Su rv ey s M on th ly A nn ua lly O nc e in 2 ye ar s Pr op or ti on o f c ar eg iv er s of c hi ld re n 6 to 2 3 m on th s re ce iv in g co un se lin g on u se o f M N Ps Ca re gi ve rs o f c hi ld re n 6 to 2 3 m on th s re ce iv in g co un se lin g on u se o f M N Ps N um be r of ca re gi ve rs o f ch ild re n 6 to 2 3 m on th s re ce iv in g co un se lin g on u se o f M N Ps To ta l n um be r of c hi ld re n 6 to 2 3 m on th s sa m pl ed in th e su rv ey a re a Pe rc en ta ge SM A RT s ur ve ys K A P su rv ey s A nn ua lly on ce in 2 ye ar s Pr op or ti on o f c ar eg iv er s of ch ild re n 6 to 2 3 m on th s w it h co rr ec t k no w le dg e on th e fr eq ue nc y of g iv in g M N Ps Ca re gi ve rs o f c hi ld re n 6 to 2 3 m on th s w it h th e co rr ec t k no w le dg e on fr eq ue nc y of g iv in g M N Ps N um be r of ca re gi ve rs o f ch ild re n 6 to 2 3 m on th s w ho g iv e co rr ec t k no w le dg e on M N Ps fr eq ue nc y To ta l n um be r of ca re gi ve rs o f c hi ld re n 6 to 2 3 m on th s in th e co un tr y/ co un ty /s am pl ed Pe rc en ta ge K A P su rv ey s Ev er y 2 ye ar s Pr op or ti on o f c ar eg iv er s of c hi ld re n 6 to 2 3 m on th s re ce iv in g M N Ps fo r 6 co nt in uo us m on th s Ca re gi ve rs o f c hi ld re n 6 to 2 3 m on th s re ce iv in g M N Ps a s pe r th e sc he du le N um be r of ca re gi ve rs o f ch ild re n 6 to 2 3 m on th s re ce iv in g M N Ps fo r 6 co nt in uo us m on th s To ta l n um be r of c hi ld re n 6 to 2 3 m on th s in th e ca tc hm en t p op ul at io n or to ta l n um be r of c hi ld re n sa m pl ed in a s ur ve y Pe rc en ta ge SM A RT s ur ve ys K A P su rv ey s 71 1 A nn ua lly O nc e in 2 ye ar s Pr op or ti on o f c ar eg iv er s of c hi ld re n 6 to 2 3 m on th s re po rt in g co ns um pt io n of 8 0% of M N Ps s ac he ts in th e la st 6 m on th s Ch ild re n 6 to 23 m on th s w ho co nt in uo us ly r ec ei ve s M N Ps a nd c on su m es at le as t 8 0% o f M N Ps N um be r of c hi ld re n 6 to 2 3 m on th s w ho co ns um ed 8 0% o f M N Ps r ec ei ve d in th e pa st 6 m on th s N um be r of c hi ld re n 6 to 23 m on th s in c at ch m en t po pu la ti on o r sa m pl ed in a su rv ey Pe rc en ta ge M oH 7 11 SM A RT S ur ve y K A B P Su rv ey M on th ly A nn ua lly O nc e in tw o ye ar s Pr op or ti on o f c ar eg iv er s w it h ch ild re n 6 to 2 3 m on th s re po rt in g no n co ns um pt io n of M N Ps d ue to a ny b ar ri er Ca re gi ve rs o f c hi ld re n 6 to 2 3 m on th s w ho r ep or t n on co ns um pt io n of M N Ps by th e ch ild re n du e to na y ba rr ie r N um be r of ca re gi ve rs o f ch ild re n 6 to 2 3 m on th s re po rt in g no n co ns um pt io n of M N Ps d ue to a ny re as on N um be r of c hi ld re n 6 to 2 3 m on th s in th e ca tc hm en t p op ul at io n or sa m pl ed in th e su rv ey Pe rc en ta ge SM A RT s ur ve y K A P su rv ey A nn ua lly O nc e in tw o ye ar s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 85 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g In te rp re ta ti on Co m m un it y se rv ic e Pr op or ti on o f c om m un it y un it s w it h CH Vs s en si ti ze d on M N Ps Co m m un it y un it s w it h CH Vs s en si ti ze d on t M N Ps N um be r of co m m un it y un it s w it h CH Vs s en si ti ze d on th e us e an d im po rt an ce o f M N Ps To ta l n um be r of co m m un it y un it s in th e co un tr y/ co un ty o r sa m pl ed c om m un it y un it s in a s ur ve y Pe rc en ta ge K A P su rv ey LQ A S Ev er y 2 ye ar s A nn ua lly Pe rc en ta ge o f c ar eg iv er s of ch ild re n 6 to 2 3 m on th s w ho ha ve b ee n re fe rr ed fo r M N Ps se rv ic es fr om th e co m m un it y Ca re gi ve rs o f c hi ld re n 6 to 2 3 m on th s be in g re fe rr ed b y CH Vs fo r M N Ps s er vi ce s N um be r of ca re gi ve rs o f ch ild re n 6 to 2 3 m on th s re fe rr ed by C H Vs fo r M N Ps se rv ic es To ta l n um be r of c hi ld re n 6 to 2 3 m on th s in th e ca tc hm en t p op ul at io n or sa m pl ed in a s ur ve y Pe rc en ta ge K A P su rv ey Ev er y 2 ye ar s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202286 A n n ex 2 .3 In di ca to rs to a ss es s IF A S pr og ra m m es In 2 01 5, th e K en ya n ut ri ti on s ec to r ad op te d ke y in di ca to rs d ur in g a da ta c lin ic a s ta bu la te d be lo w : In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f m ea su re D at a co ll ec ti on m et ho ds R ep or ti n g In te rp re ta ti on / co m m en ts Co n su m pt io n Pr op or ti on o f p re gn an t w om en c on su m in g fo lic IF A S in th e fir st tr im es te r of p re gn an cy o f t he ir la st bi rt h Pe rc en ta ge o f p re gn an t w om en w ho c on su m ed IF A S in th e fir st tr im es te r of p re gn an cy of th ei r la st b ir th # o f p re gn an t w om en re po rt in g ha vi ng co ns um ed IF A S du ri ng th e fir st tr im es te r of pr eg na nc y of th ei r la st bi rt h N um be r of w om en w it h a liv e bi rt h sa m pl ed in th e su rv ey Pe rc en ta ge Ca re gi ve rs w it h ch ild re n un de r tw o ye ar s th ro ug h K A P, LQ A S su rv ey s B ia nn ua lly or E ve ry th re e ye ar s IF A S is v er y cr it ic al in th e fir st 2 8 da ys o f pr eg na nc y Pr op or ti on o f p re gn an t w om en r ec ei ve d IF A S du ri ng p re gn an cy o f t he ir la st b ir th Pe rc en ta ge o f p re gn an t w om en w ho r ec ei ve d IF A S d ur in g pr eg na nc y of th ei r la st b ir th # o f p re gn an t w om en re po rt in g ha vi ng re ce iv ed IF A S du ri ng pr eg na nc y of th ei r la st bi rt h N um be r of w om en w it h a liv e bi rt h sa m pl ed in th e su rv ey Pe rc en ta ge Ca re gi ve rs w it h ch ild re n un de r tw o ye ar s th ro ug h K A P, nu tr it io n SM A RT su rv ey s B ia nn ua lly or E ve ry th re e ye ar s IF A S is v er y cr it ic al du ri ng p re gn an cy Pr op or ti on o f w om en ta ki ng IF A S du ri ng pr eg na nc y Pe rc en ta ge o f w om en ta ki ng IF A S fo r le ss th an 9 0, 9 0 18 0, 1 81 27 0, m or e th an 2 70 da ys d ur in g pr eg na nc y of th ei r la st b ir th # o f w om en ta ki ng IF A S fo r le ss th an 9 0, 90 1 80 , 1 81 2 70 , m or e th an 2 70 d ay s du ri ng p re gn an cy o f th ei r la st b ir th To ta l n um be r of w om en s am pl ed / in te rv ie w ed Pe rc en ta ge Ca re gi ve rs w it h ch ild re n un de r tw o ye ar s th ro ug h K A P, LQ A S su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 87 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f m ea su re D at a co ll ec ti on m et ho ds R ep or ti n g In te rp re ta ti on / co m m en ts K n ow le dg e Pr op or ti on o f w om en w ho c an c it e at le as t 2 be ne fit s of ta ki ng IF A S Pe rc en ta ge o f w om en w ho c an c it e tw o be ne fit s of ta ki ng IF A S N um be r of w om en (1 5 49 y ea rs ) w ho ca n de sc ri be a t l ea st 2 be ne fit s of ta ki ng IF A S du ri ng p re gn an cy N um be r of w om en 15 to 4 9 ye ar s Pe rc en ta ge Ca re gi ve rs w it h ch ild re n un de r tw o ye ar s th ro ug h K A P, LQ A S su rv ey s Pr op or ti on o f w om en w ho r ep or t t o ha ve h ea rd or s ee n IF A S m es sa ge s Pe rc en ta ge o f w om en w ho r ep or t t o ha ve he ar d or s ee n m es sa ge s on IF A S N um be r of w om en w ho r ep or t t o ha ve he ar d or s ee n an y in fo rm at io n on IF A S N um be r of w om en sa m pl ed Pe rc en ta ge Ca re gi ve rs w it h ch ild re n un de r tw o ye ar s th ro ug h K A P, LQ A S su rv ey s Pr op or ti on o f w om en w ho r ep or t o f f ro nt lin e w or ke rs th at p ro vi de co un se lli ng o n ov er co m in g ba rr ie rs to ut ili za ti on o f I FA S Pe rc en ta ge o f w om en re po rt in g th at fr on tl in e he al th w or ke rs pr ov id ed th em w it h co un se lin g on h ow to ov er co m e ba rr ie rs to ut ili za ti on o f I FA S N um be r of w om en w ho r ep or t o f f ro nt lin e w or ke rs th at p ro vi de co un se lli ng o n ov er co m in g ba rr ie rs to ut ili za ti on o f I FA S N um be r of w om en sa m pl ed Pe rc en ta ge Ca re gi ve rs w it h ch ild re n un de r tw o ye ar s th ro ug h K A P, LQ A S su rv ey s Co m m od it y av ai la bi li ty Pr op or ti on o f H ea lt h fa ci lit ie s th at d o no t h av e IF A S St oc k ou ts Pe rc en ta ge o f H ea lt h fa ci lit ie s th at d o no t ha ve IF A S St oc k ou ts N um be r of h ea lt h fa ci lit ie s th at d o no t h av e IF A S st oc k ou ts To ta l n um be r of h ea lt h fa ci lit ie s sa m pl ed Pe rc en ta ge Fr on tl in e he al th ca re p ro vi de rs th ro ug h LQ A S su rv ey s H um an r es ou rc e Pr op or ti on o f h ea lt h w or ke rs p ro vi di ng IF A S Su pp le m en ta ti on s er vi ce s Pe rc en ta ge o f h ea lt h w or ke rs p ro vi di ng IF A S Su pp le m en ta ti on se rv ic es # o f h ea lt h w or ke rs pr ov id in g IF A S se rv ic es To ta l n um be r of h ea lt h w or ke rs sa m pl ed /i nt er vi ew ed Pe rc en ta ge Fr on tl in e he al th ca re p ro vi de rs th ro ug h LQ A S su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202288 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f m ea su re D at a co ll ec ti on m et ho ds R ep or ti n g In te rp re ta ti on / co m m en ts Pr op or ti on o f h ea lt h w or ke rs p ro vi di ng IF A S su pp le m en ta ti on se rv ic es w ho h av e ev er b ee n tr ai ne d on IF A S su pp le m en ta ti on gu id el in es Pe rc en ta ge o f h ea lt h w or ke rs p ro vi di ng IF A S su pp le m en ta ti on se rv ic es w ho h av e ev er b ee n tr ai ne d on IF A S su pp le m en ta ti on gu id el in es # o f h ea lt h w or ke rs tr ai ne d on IF A S ba se d on M O H cu rr ic ul um To ta l n um be r of fr on tl in e he al th c ar e w or ke rs s am pl ed / in te rv ie w ed Pe rc en ta ge Fr on tl in e he al th ca re p ro vi de rs th ro ug h LQ A S su rv ey s Pr op or ti on o f h ea lt h fa ci lit y st af f i n pl ac e ne ed ed to d el iv er IF A S se rv ic es # o f h ea lt h fa ci lit y st af f de liv er in g IF A S se rv ic es To ta l n um be r of h ea lt h fa ci lit y st af f Pe rc en ta ge Fr on tl in e he al th ca re p ro vi de rs th ro ug h LQ A S su rv ey s G eo gr ap hi ca l C ov er ag e Pr op or ti on o f h ea lt h fa ci lit ie s of fe ri ng IF A S Su pp le m en ta ti on Pe rc en ta ge o f h ea lt h fa ci lit ie s of fe ri ng IF A S Se rv ic es # o f h ea lt h fa ci lit ie s of fe ri ng IF A S To ta l n um be r of h ea lt h fa ci lit ie s sa m pl ed /v is it ed Pe rc en ta ge Fr on tl in e he al th ca re p ro vi de rs th ro ug h LQ A S su rv ey s Co m m un it y Se rv ic e Pr op or ti on o f p re gn an t w om en w ho h av e be en re fe rr ed to th e A N C fr om th e co m m un it y Pr op or ti on o f p re gn an t w om en w ho h av e be en re fe rr ed to th e A N C fr om th e co m m un it y # o f pr eg na nt w om en re fe rr ed fo r A N C se rv ic es b y CH Vs To ta l n um be r of w om en sa m pl ed Pe rc en ta ge Ca re p ro vi de rs w it h ch ild re n le ss th an 2 4 m on th s th ro ug h LQ A S su rv ey s, M IY CN K A B P Th is in di ca to r is to a ss es s co nt ri bu ti on o f C H S to A N C se rv ic es Pr op or ti on o f p re gn an t w om en a tt en di ng A N C ea rl y (1 st tr im es te r) Pe rc en ta ge o f p re gn an t w om en a tt en di ng A N C ea rl y (1 st tr im es te r) # o f pr eg na nt w om en at te nd in g A N C se rv ic es in th e fir st tr im es te r To ta l n um be r of p re gn an t w om en a tt en di ng A N C Pe rc en ta ge Ca re p ro vi de rs w it h ch ild re n le ss th an 2 4 m on th s th ro ug h LQ A S su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 89 In di ca to r D es cr ip ti on N um er at or D en om in at or U n it o f m ea su re D at a co ll ec ti on m et ho ds R ep or ti n g In te rp re ta ti on / co m m en ts Pr op or ti on o f C om m un it y Vo lu nt ee rs th at a re tr ai ne d on IF A S Pe rc en ta ge o f Co m m un it y Vo lu nt ee rs th at a re tr ai ne d on IF A S # o f co m m un it y he al th vo lu nt ee rs tr ai ne d on IF A S To ta l n um be r of c om m un it y he al th v ol un te er s Pe rc en ta ge Co m m un it y he al th v ol un te er s th ro ug h LQ A S su rv ey s Pr op or ti on o f P LW g iv en fa m ily s up po rt Pe rc en ta ge o f P LW gi ve n fa m ily s up po rt # o f P LW re po rt in g th at th ey re ce iv ed su pp or t fr om a ny fa m ily m em be r on A N C se rv ic es To ta l n um be r of P LW s am pl ed / in te rv ie w ed Pe rc en ta ge LQ A S, K A B P V it am in A s up pl em en ta ti on : I n di ca to r ca lc ul at io n o f r ou ti n e da ta Th e D is tr ic t H ea lt h In fo rm at io n So ft w ar e (K H IS ) is u se d m on th ly to r ep or t o n ro ut in e vi ta m in A s up pl em en ta ti on s er vi ce s (h tt ps :/ /h is ke ny a. or g) . V it am in A da ta o f ch ild re n 6 59 m on th s is c ol le ct ed o n im m un iz at io n ta lly s he et ( M O H 70 2) a nd r ep or te d on im m un iz at io n su m m ar y re po rt t oo l ( M O H 7 10 ) in t he D H IS a gg re ga te d by a ge a nd o rg an iz at io na l u ni t. Th is in di ca to r i s t ra ck ed o n m on th ly b as is b y cu m ul at in g th e nu m be rs a ch ie ve d ag ai ns t t he s et s em es te r ta rg et . C ov er ag e is c om pu te d on s em es te r ba si s i.e . 6 m on th s’ i nt er va l (J an ua ry t o Ju ne a nd J ul y to D ec em be r as f ir st a nd s ec on d se m es te r re sp ec tiv el y) . T o co m pu te a nn ua l c ov er ag e, th e lo w er c ov er ag e of th e tw o se m es te rs i s co ns id er ed . C al cu la ti on o f co ve ra ge u si ng r ou ti ne d at a pe r se m es te r • Pr op or ti on o f ch ild re n 6 11 m on th s w ho r ec ei ve d on e do se o f vi ta m in A (1 00 ,0 00 IU ) = (N um be r of c hi ld re n 6 11 m on th s su pp le m en te d w it h on e do se o f V it am in A ) / (T ot al n um be r of c hi ld re n ag ed 6 1 1 m on th s) X 1 00 • Pr op or ti on o f c hi ld re n 12 5 9 m on th s w ho r ec ei ve d on e do se o f v it am in A (2 00 ,0 00 IU ) = (N um be r o f c hi ld re n 12 5 9 m on th s su pp le m en te d w it h on e do se o f V it am in A ) / (T ot al n um be r of c hi ld re n ag ed 1 2 59 m on th s) X 1 00 • Pr op or ti on o f c hi ld re n 6 59 m on th s w ho r ec ei ve d on e do se o f v it am in A (a ge a pp ro pr ia te ) = (N um be r of c hi ld re n 6 59 m on th s su pp le m en te d w it h on e do se o f a ge a pp ro pr ia te V it am in A ) / (T ot al n um be r of c hi ld re n ag ed 6 59 m on th s) X 1 00 In di ca to rs to a ss es s fo r vi ta m in A s up pl em en ta ti on in po pu la ti on b as ed s ur ve ys In di ca to rs t o as se ss v it am in s up pl em en ta ti on s ho ul d co ve r th e fo llo w in g co m po ne nt s: a va ila bi lit y of v it am in A s up pl em en ts , av ai la bi lit y of h um an re so ur ce e .g . w he th er t he re a re a de qu at el y tr ai ne d he al th w or ke rs /h ea lt h w or kf or ce to ad m in is te r v it am in A su pp le m en ts , a cc es s, co ve ra ge an d ut ili za ti on of v it am in A s er vi ce s. T he k ey in di ca to rs fo r vi ta m in A s up pl em en ta ti on a re pr es en te d in T ab le 2 5. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202290 An ne x 2. 4 Ke y In di ca to rs fo r VA S In di ca to r D es cr ip ti on D at a co ll ec ti on m et ho ds N um er at or D en om in at or U n it o f m ea su re R ep or ti n g In te rp re ta ti on / co m m en ts U ti li za ti on Pr op or ti on of c hi ld re n 6 59 m on th s co ve re d w it h ag e ap pr op ri at e do se s of V it am in A su pp le m en ta ti on w it hi n on e ye ar . Pe rc en ta ge o f C hi ld re n ag ed 6 1 1 m on th s w ho re ce iv ed o ne d os e of vi ta m in A a nd th os e ag ed 1 2 59 m on th s w ho re ce iv ed tw o do se s of vi ta m in A s up pl em en t w it hi n on e ye ar . D H IS N um be r of c hi ld re n su pp le m en te d w it h ag e ap pr op ri at e do se s of V it am in A w it hi n on e ye ar in th e ro ut in e To ta l n um be r of ch ild re n ag ed 6 1 1 an d 12 5 9 m on th s in th e ca tc hm en t ar ea Pe rc en ta ge D at a ar e re po rt ed m on th ly fr om th e se rv ic e de liv er y un it s to th e su b co un ty fo r en tr y. O nc e en te re d, th e da ta a re a va ila bl e at al l l ev el s A ll pl ac es i. e. Co un ti es , S ub co un ti es w it h a tw o do se c ov er ag e es ti m at e of ≥ 80 % w ill b e co ns id er ed as h av in g ac hi ev ed th e ta rg et . SM A RT LQ A S N um be r of c hi ld re n su pp le m en te d w it h ag e ap pr op ri at e do se s of V it am in A w it hi n on e ye ar in th e su rv ey To ta l n um be r of ch ild re n ag ed 6 1 1, 12 5 9 an d 6 59 m on th s in th e su rv ey Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed . Pr op or ti on o f Ch ild re n ag ed 6 11 m on th s w ho re ce iv ed o ne d os e of 1 00 ,0 00 IU vi ta m in A Pe rc en ta ge o f C hi ld re n ag ed 6 1 1 m on th s w ho re ce iv ed o ne d os e of 10 0, 00 0 IU v it am in A LQ A S/ In te gr at ed N ut ri ti on S M A RT su rv ey N um be r of c hi ld re n ag ed 6 1 1 m on th s su pp le m en te d w it hi n th e su rv ey To ta l n um be r of ch ild re n ag ed 6 1 1 in th e su rv ey Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Pr op or ti on o f ch ild re n 12 5 9 m on th s w ho re ce iv ed tw o do se s of V A S w it hi n n ye ar % o f c hi ld re n ag ed 1 2 59 m on th s w ho r ec ei ve d tw o do se s of v it am in A su pp le m en t w it hi n on e ye ar . LQ A S/ In te gr at ed N ut ri ti on S M A RT su rv ey /M oH 2 16 # o f c hi ld re n 12 59 m on th s w ho re ce iv ed tw o do se s of V A S w it hi n on e ye ar To ta l n um be r of ch ild re n ag ed 1 2 59 m on th s in th e su rv ey Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Pr op or ti on o f Ch ild re n ag ed 6 59 m on th s w ho re ce iv ed o ne d os e of v it am in A Pe rc en ta ge o f C hi ld re n ag ed 6 5 9 m on th s w ho re ce iv ed o ne d os e of vi ta m in A LQ A S/ In te gr at ed N ut ri ti on S M A RT su rv ey N um be r of c hi ld re n ag ed 6 5 9 m on th s su pp le m en te d w it hi n th e su rv ey To ta l n um be r of ch ild re n ag ed 6 5 9 in th e su rv ey Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 91 In di ca to r D es cr ip ti on D at a co ll ec ti on m et ho ds N um er at or D en om in at or U n it o f m ea su re R ep or ti n g In te rp re ta ti on / co m m en ts K n ow le dg e Pr op or ti on o f ca re gi ve rs w ho c an gi ve a t l ea st tw o be ne fit s of V A S % o f c ar eg iv er s (w it h ch ild re n) w ho c an c it e at le as t t w o be ne fit s of V A S at th e ti m e of s ur ve y K PC /L Q A S/ In te gr at ed N ut ri ti on SM A RT s ur ve y # o f c ar eg iv er s w ho ca n ci te a t l ea st tw o be ne fit s of V A S at th e ti m e of s ur ve y To ta l nu m be r of c ar eg iv er s w it h ch ild re n in te rv ie w ed / sa m pl ed Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Co m m od it y a va il ab il it y Pr op or ti on o f H ea lt h fa ci lit ie s th at re po rt s to h av e VA S st oc k ou ts N um be r of H ea lt h fa ci lit ie s th at r ep or ts to h av e st oc k ou ts fo r th e pa st o ne y ea r LQ A S/ D H IS # o f H F th at h av e re po rt ed s to ck o ut s in th e pa st o ne y ea r A ll fa ci lit ie s th at ha ve r ep or te d Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed H um an R es ou rc e Pr op or ti on o f he al th w or ke rs pr ov id in g VA S at se rv ic e de liv er y po in ts Pr op or ti on o f h ea lt h w or ke rs p ro vi di ng V A S se rv ic es LQ A S # o f h ea lt h w or ke rs pr ov id in g VA S se rv ic es To ta l n um be r of he al th w or ke rs w or ki ng a t V A S se rv ic e de liv er y po in ts Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Pr op or ti on o f H W pr ov id in g VA S se rv ic es w ho h av e ev er b ee n tr ai ne d on V A S gu id el in es % o f H W p ro vi di ng V A S se rv ic es w ho h av e ev er be en tr ai ne d on V A S gu id el in es LQ A S # o f H W p ro vi di ng VA S se rv ic es w ho ha ve e ve r be en tr ai ne d on V A S gu id el in es To ta l n um be r of H W p ro vi di ng V A S se rv ic es Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Pr op or ti on o f he al th fa ci lit ie s st af f i n pl ac e to de liv er V A S se rv ic es # o f s ta ff d el iv er in g VA S se rv ic es LQ A S # o f s ta ff in p la ce de liv er in g VA S se rv ic es To ta l n um be r of he al th fa ci lit ie s’ st af f Pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202292 In di ca to r D es cr ip ti on D at a co ll ec ti on m et ho ds N um er at or D en om in at or U n it o f m ea su re R ep or ti n g In te rp re ta ti on / co m m en ts G eo gr ap hi ca l C ov er ag e Pr op or ti on o f H ea lt h Fa ci lit ie s of fe ri ng V A S # o f H F of fe ri ng V A S LQ A S To ta l n o. o f h ea lt h fa ci lit ie s of fe ri ng VA S se rv ic es To ta l n um be r of he al th fa ci lit ie s vi si te d pe rc en ta ge D at a is R ep or te d ev er y ti m e a su rv ey is c on du ct ed Pr op or ti on of c hi ld re n su pp le m en te d in EC D N um be r of c hi ld re n su pp le m en te d in E CD N um be r of c hi ld re n su pp le m en te d in EC D To ta l n um be r of ch ild re n el ig ib le fo r VA S in E CD pe rc en ta ge Pr og ra m m es r ep or ts Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 93 A n n ex 2 . 5 In di ca to rs fo r M ot he r In fa n t a n d Yo un g ch il d fe ed in g pr ac ti ce s (M IY CN ) In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pe rc en ta ge o f l as t bo rn c hi ld re n ag e 0– 23 m on th s w ho w er e pu t t o th e br ea st w it hi n 1 ho ur o f d el iv er y Ea rl y in it ia ti on o f br ea st fe ed in g Pr ac ti ce N um be r of la st bo rn c hi ld re n ag e 0– 23 m on th s w ho w er e pu t t o th e br ea st w it hi n 1 ho ur o f d el iv er y To ta l n um be r of la st b or n ch ild re n ag e 0– 23 m on th s in th e su rv ey Co re Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ur it io n su rv ey s D is ag gr eg at io n: It is re co m m en de d th at th is in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r (i ) liv e bi rt hs o f c hi ld re n 0 11 m on th s; a nd ( ii) li ve b ir th s of c hi ld re n 12 2 3 m on th s, if sa m pl e si ze p er m it s Pr op or ti on o f ca re gi ve rs o f ch ild re n 0 23 m on th s w ho k no w at le as t t w o be ne fit s of E ar ly In it ia ti on o f br ea st fe ed in g K no w le dg e N um be r of ca re gi ve rs w ho kn ow a t l ea st 2 be ne fit s of e ar ly in it ia ti on N um be r of ca re gi ve rs w it h ch ild re n 0 23 m on th s Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Pe rc en ta ge o f in fa nt s 0– 5 m on th s of a ge w ho a re fe d ex cl us iv el y w it h br ea st m ilk Ex cl us iv e br ea st fe ed in g un de r 6 m on th s Pr ac ti ce In fa nt s 0– 5 m on th s of a ge w ho r ec ei ve d on ly b re as t m ilk d ur in g th e pr ev io us d ay In fa nt s 0– 5 m on th s of a ge Co re Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Ex cl us iv e br ea st fe ed in g m ea ns th at th e in fa nt r ec ei ve d br ea st m ilk ( in cl ud in g m ilk e xp re ss ed or fr om a w et n ur se ) an d m ig ht ha ve r ec ei ve d or al r eh yd ra ti on so lu ti on ( O R S) , v it am in s, m in er al s, a nd /o r m ed ic in es , b ut di d no t r ec ei ve a ny o th er fo od or li qu id . T he in di ca to r is b as ed on r ec al l o f t he p re vi ou s da y fo r al l l iv in g in fa nt s 0 5 m on th s. D is ag gr eg at io n: It is re co m m en de d th at th e in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r th e fo llo w in g ag e gr ou ps : 0 1 m on th , 2 3 m on th s, 4 5 m on th s an d 0 3 m on th s, if s am pl e si ze pe rm it s. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202294 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on of c ar eg iv er s w it h ch ild re n 0 23 m on th s w ho kn ow a t l ea st tw o be ne fit s of e xc lu si ve br ea st fe ed in g K no w le dg e N um be r of ca re gi ve rs w it h ch ild re n 0 23 m on th s w ho k no w a t le as t 2 b en ef it s of e xc lu si ve br ea st fe ed in g N um be r of ca re gi ve rs w it h ch ild re n 0 23 m on th s of ag e Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Pr op or ti on o f ch ild re n bo rn in th e la st 2 4 m on th s w ho w er e ev er b re as tf ed Ch ild re n ev er br ea st fe d Pr ac ti ce Ch ild re n bo rn in th e la st 2 4 m on th s w ho w er e ev er b re as tf ed Ch ild re n bo rn in th e la st 24 m on th s as se ss ed A dd it io na l Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s D is ag gr eg at io n: It is re co m m en de d th at th e in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r (i ) liv e bi rt hs o cc ur ri ng in th e la st 1 2 m on th s; a nd ( ii) liv e bi rt hs o cc ur ri ng b et w ee n th e la st 1 2 an d 24 m on th s, if sa m pl e si ze p er m it s Pe rc en ta ge o f ch ild re n 12 –1 5 m on th s of a ge w ho ar e fe d br ea st m ilk Co nt in ue d br ea st fe ed in g at 1 y ea r A dd it io na l Ch ild re n 12 –1 5 m on th s of a ge w ho r ec ei ve d br ea st m ilk du ri ng th e pr ev io us d ay Ch ild re n 12 –1 5 m on th s of a ge Po pu la ti on le ve l su rv ey s Th e in di ca to r ha s a re la tiv el y na rr ow a ge r an ge o f 4 m on th s, es ti m at es fr om s ur ve ys w it h sm al l s am pl e si ze s ar e lik el y to ha ve w id e co nf id en ce in te rv al s. Th is in di ca to r in cl ud es br ea st fe ed in g by a w et n ur se an d fe ed in g ex pr es se d m ilk . T he in fa nt c an r ec ei ve b re as tm ilk ei th er b y br ea st fe ed in g or an ot he r m ea ns . Pe rc en ta ge o f ch ild re n 20 –2 3 m on th s of a ge w ho ar e fe d br ea st m ilk Co nt in ue d br ea st fe ed in g at 2 y ea rs (C or e) Pr ac ti ce Ch ild re n 20 –2 3 m on th s of a ge w ho r ec ei ve d br ea st m ilk du ri ng th e pr ev io us d ay Ch ild re n 20 –2 3 m on th s of a ge Co re Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 95 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on o f ca re gi ve rs o f ch ild re n 0– 23 m on th s w ho a re aw ar e th at a c hi ld sh ou ld c on ti nu e br ea st fe ed in g to tw o ye ar s an d be yo nd K no w le dg e N um be r of ca re gi ve rs w ho kn ow a t l ea st tw o be ne fit s of c on ti nu ed br ea st fe ed in g to tw o ye ar s an d be yo nd N um be r of ca re gi ve rs w it h ch ild re n 0 23 m on th s of a ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Pe rc en ta ge o f in fa nt s 6– 8 m on th s of a ge w ho r ec ei ve so lid , s em i so lid , o r so ft fo od s In tr od uc ti on of s ol id , s em i so lid , o r so ft fo od s— ch ild re n (C or e) In fa nt s 6– 8 m on th s of a ge w ho r ec ei ve s ol id , se m i so lid , o r so ft fo od s du ri ng th e pr ev io us d ay In fa nt s 6– 8 m on th s of a ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Pr op or ti on o f ca re gi ve rs w it h ch ild re n 6 23 w ho k no w th e ap pr op ri at e ti m e of in tr od uc ti on o f so lid , s em i so lid , o r so ft fo od s N um be r of ca re gi ve rs w it h ch ild re n 6 23 w ho k no w th e ap pr op ri at e ti m e of in tr od uc ti on o f so lid , s em i so lid , or s of t f oo ds N um be r of m ot he rs w it h ch ild re n 6 23 m on th s of a ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Pe rc en ta ge o f ch ild re n 6– 23 m on th s of a ge w ho re ce iv ed a n ir on ri ch fo od in th e la st 24 h ou rs Co ns um pt io n of ir on r ic h fo od s Pr ac ti ce Ch ild re n 6– 23 m on th s of a ge w ho r ec ei ve d an ir on r ic h fo od du ri ng th e la st 2 4 ho ur s Ch ild re n 6– 23 m on th s of a ge Co re Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s N ot es : S ui ta bl e ir on r ic h or ir on f or ti fie d fo od s in cl ud e fle sh fo od s, c om m er ci al ly fo rt ifi ed fo od s sp ec ia lly de si gn ed fo r in fa nt s an d yo un g ch ild re n w hi ch c on ta in ir on , or fo od s fo rt ifi ed in th e ho m e w it h a m ic ro nu tr ie nt p ow de r co nt ai ni ng ir on o r a lip id b as ed nu tr ie nt s up pl em en t c on ta in in g ir on . D is ag gr eg at io n: It is re co m m en de d th at th e in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r th e fo llo w in g ag e gr ou ps : 6 1 1 m on th s, 1 2 17 m on th s an d 18 2 3 m on th s, if s am pl e si ze pe rm it s. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202296 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on o f ca re gi ve rs w it h ch ild re n 6 23 m on th s w ho c an na m e at le as t t w o fo od s ou rc es o f i ro n K no w le dg e Pr op or ti on o f ca re gi ve rs w it h ch ild re n 6 23 m on th s w ho c an na m e at le as t t w o fo od s ou rc es o f ir on N um be r of ca re gi ve rs w it h Ch ild re n 6– 23 m on th s of a ge Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Pr op or ti on o f br ea st fe d an d no n br ea st fe d ch ild re n 6– 23 m on th s of ag e w ho r ec ei ve d so lid , s em i so lid , o r so ft fo od s (b ut a ls o in cl ud in g m ilk fe ed s fo r no n br ea st fe d ch ild re n) th e m in im um n um be r of ti m es o r m or e M in im um m ea l fr eq ue nc y— ch ild re n Pr ac ti ce B re as tf ed ch ild re n 6 23 m on th s w ho re ce iv ed s ol id , se m i so lid o r so ft fo od s th e m in im um n um be r of ti m es o r m or e du ri ng th e pr ev io us d ay B re as tf ed ch ild re n 6 23 m on th s ol d Co re Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s N ot e; ‘M ea ls ’ i nc lu de b ot h m ea ls a nd s na ck s (o th er th an tr iv ia l a m ou nt s) , a nd fr eq ue nc y is b as ed o n ca re gi ve r re po rt M in im um is d ef in ed a s: 2 ti m es fo r br ea st fe d in fa nt s 6– 8 m on th s 3 ti m es fo r br ea st fe d ch ild re n 9– 23 m on th s 4 ti m es fo r no n br ea st fe d ch ild re n 6– 23 m on th s D is ag gr eg at io n: It is re co m m en de d th at th e in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r th e fo llo w in g ag e gr ou ps : 6 11 m on th s, 1 2 17 m on th s, an d 18 2 3 m on th s, if s am pl e si ze p er m it s. R es ul ts m ay a ls o be r ep or te d se pa ra te ly fo r br ea st fe d an d no n br ea st fe d ch ild re n. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 97 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pe rc en ta ge o f ch ild re n 6– 23 m on th s of a ge w ho re ce iv e fo od s fr om fiv e o r m or e fo od gr ou ps M in im um di et ar y di ve rs it y— ch ild re n (C or e) Ch ild re n 6– 23 m on th s of a ge w ho r ec ei ve d fo od s fr om ≥ fiv e fo od g ro up s du ri ng th e pr ev io us d ay Ch ild re n 6– 23 m on th s of a ge Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s M in im um d ie ta ry d iv er si ty fo r br ea st fe d ch ild re n 6– 23 m on th s is d ef in ed a s fiv e or m or e fo od s fr om th e fo llo w in g ei gh t f oo d gr ou ps W he n sa m pl e si ze s al lo w , di sa gg re ga te d da ta s ho ul d be p re se nt ed b y se x, a ge an d br ea st fe ed in g st at us . R ec om m en de d ag e gr ou ps fo r re po rt in g ar e 6– 11 m on th s, 12 –1 7 m on th s an d 18 –2 3 m on th s of a ge . I t m ay a ls o be us ef ul to d is ag gr eg at e by p la ce of r es id en ce , s oc io ec on om ic st at us ( e. g. , w ea lt h qu in ti le ), an d m at er na l e du ca ti on 8 FO O D G R O U PS IN M D D 1. B re as t m ilk 2. G ra in s, w hi te r oo ts a nd tu be rs , a nd p la nt ai ns 3. L eg um es a nd N ut s 4. D ai ry 5. F le sh fo od s (m ea t, fis h, po ul tr y an d liv er /o rg an m ea ts ) 6. E gg s 7. V it am in A r ic h fr ui ts a nd ve ge ta bl es 8. O th er fr ui ts a nd v eg et ab le s Pr op or ti on o f ca re gi ve rs w ho ca n na m e at le as t fo ur fo od g ro up s fo r ch ild re n 6 23 m on th s of a ge N um be r of ca re gi ve rs w ho ca n na m e at le as t fo ur fo od g ro up s fo r ch ild re n 6 23 m on th s of a ge N um be r of ca re gi ve rs w it h ch ild re n 6 23 m on th s of a ge Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 202298 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on o f ch ild re n 6– 23 m on th s of a ge w ho re ce iv ed a m in im um ac ce pt ab le d ie t (a pa rt fr om b re as t m ilk ) M in im um ac ce pt ab le di et – ch ild re n B re as tf ed ch ild re n 6– 23 m on th s of a ge w ho h ad a t l ea st th e m in im um di et ar y di ve rs it y an d th e m in im um m ea l f re qu en cy du ri ng th e pr ev io us d ay B re as tf ed ch ild re n 6– 23 m on th s of a ge Co re Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s D is ag gr eg at io n: It is re co m m en de d th at th e in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r th e fo llo w in g ag e gr ou ps : 6 1 1 m on th s, 1 2 17 m on th s, a nd 18 2 3 m on th s, if s am pl e si ze pe rm it s. N on b re as tf ed ch ild re n 6– 23 m on th s of a ge w ho h ad a t l ea st tw o m ilk fe ed in gs an d ha ve a t l ea st th e m in im um di et ar y di ve rs it y no t i nc lu di ng m ilk fe ed s an d th e m in im um m ea l fr eq ue nc y du ri ng th e pr ev io us d ay N on b re as tf ed ch ild re n 6– 23 m on th s of a ge Pe rc en ta ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Pr op or ti on o f ca re gi ve rs o f ch ild re n 6 23 m on th s of a ge w ho kn ow th e m in im um nu m be r of ti m es th ei r ch ild re n sh ou ld b e gi ve n m ea ls in a d ay N um be r of ca re gi ve rs o f ch ild re n 6 23 m on th s of a ge w ho k no w th e m in im um n um be r of ti m es th ei r ch ild re n sh ou ld be g iv en m ea ls in a da y N um be r of ca re gi ve rs w it h ch ild re n 6 23 m on th s of a ge Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 99 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pe rc en ta ge o f l as t bo rn c hi ld re n ag e 0– 23 m on th s w ho w er e fe d co lo st ru m Fe ed in g co lo st ru m (A dd it io na l) N um be r of la st bo rn c hi ld re n ag e 0– 23 m on th s w ho w er e fe d co lo st ru m To ta l n um be r of la st b or n ch ild re n ag e 0– 23 m on th s in th e su rv ey A dd it io na l Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Pe rc en ta ge o f m ot he rs o f c hi ld re n ag e 0– 23 m on th s w ho k no w a t l ea st on e be ne fit o f fe ed in g ba by o n co lo st ru m N um be r of m ot he rs o f ch ild re n 0– 23 m on th s w ho kn ow a t l ea st on e be ne fit o f fe ed in g ba by o n co lo st ru m To ta l n um be r of m ot he rs o f ch ild re n ag e 0– 23 m on th s in th e su rv ey Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Pe rc en ta ge o f s ic k ch ild re n ag es 0 2 3 m on th s in th e 2 w ee ks p re ce di ng th e su rv ey w ho w er e of fe re d m or e th an u su al to d ri nk (i nc lu di ng b re as t m ilk ) A pp ro pr ia te Si ck C hi ld Ca re N um be r of ch ild re n ag es 0– 23 m on th s w ho w er e of fe re d m or e th an us ua l t o dr in k (i nc lu di ng b re as t m ilk ) N um be r of ch ild re n ag es 0– 23 m on th s w ho w er e si ck in th e 2 w ee ks pr ec ed in g th e su rv ey Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s Pe rc en ta ge of m ot he rs o f ch ild re n ag e 0– 23 m on th s w ho w hi le pr eg na nt w it h th ei r yo un ge st c hi ld w er e co un se le d on nu tr it io n du ri ng pr eg na nc y N ut ri ti on co un se lin g du ri ng pr eg na nc y N um be r of m ot he rs o f ch ild re n ag e 0– 23 m on th s w ho w hi le p re gn an t w it h th ei r yo un ge st c hi ld w er e co un se le d on n ut ri ti on du ri ng p re gn an cy To ta l n um be r of m ot he rs o f ch ild re n ag e 0– 23 m on th s in th e su rv ey Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022100 In di ca to r D es cr ip ti on N um er at or D en om in at or Co re o r ad di ti on al in di ca to rs U n it o f M ea su re D at a Co ll ec ti on M et ho d R ep or ti n g Co m m en ts Pr op or ti on of w om en o f re pr od uc tiv e ag e (1 5 49 ) w ho ar e co ns um in g a m in im um d ie ta ry di ve rs it y M in im um D ie ta ry D iv er si ty — W om en (c or e) W om en o f re pr od uc tiv e ag e (1 5– 49 ) co ns um in g at le as t f iv e of th e te n M D D W fo od gr ou ps W om en o f re pr od uc tiv e ag e Co re Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s In te gr at ed S M A RT su rv ey s 10 F O O D G R O U PS IN M D D W 1. G ra in s, w hi te r oo ts a nd tu be rs , a nd p la nt ai ns 2. P ul se s (b ea ns , p ea s an d le nt ils ) 3. N ut s an d se ed s 4. D ai ry 5. M ea t, po ul tr y an d fis h 6. E gg s 7. D ar k gr ee n le af y ve ge ta bl es 8. V it am in A r ic h fr ui ts ve ge ta bl es , r oo ts a nd tu be rs 9. O th er v eg et ab le s 10 . O th er fr ui ts Pr op or ti on o f ch ild re n 0 23 m on th s ol d w ho w er e fe d w it h a bo tt le d ur in g th e pr ev io us d ay B ot tl e fe ed in g Pr ac ti ce Ch ild re n 0 23 m on th s ol d w ho w er e fe d w it h a bo tt le d ur in g th e pr ev io us d ay Ch ild re n 0 23 m on th s Co re Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Ev er y 5 ye ar s: K D H S O th er in te gr at ed he al th a nd n ut ri ti on su rv ey s N ot e: W e in cl ud e ch ild re n le ss th an 2 3 m on th s w ho r ec ei ve d an y fo od o r dr in k fr om a bo tt le w it h a ni pp le /t ea t C up w it h sp ou t o r bo tt le w it h sp oo ns d ur in g th e pr ev io us da y (i nc lu di ng b re as t m ilk ), re ga rd le ss o f w he th er o r no t th e in fa nt w as b re as tf ed . D is ag gr eg at io n: It is re co m m en de d th at th e in di ca to r be fu rt he r di sa gg re ga te d an d re po rt ed fo r th e fo llo w in g ag e gr ou ps : 0 5 m on th s, 6 1 1 m on th s, a nd 12 2 3 m on th s, if s am pl e si ze pe rm it s Pr op or ti on o f ca re gi ve rs w it h ch ild re n 0 23 m on th s of a ge w ho kn ow a t l ea st tw o co ns eq ue nc es o f bo tt le fe ed in g Pr op or ti on o f ca re gi ve rs w ho kn ow a t l ea st tw o co ns eq ue nc es o f bo tt le fe ed in g N um be r of ca re gi ve rs w it h ch ild re n 0 to 2 3 m on th s Po pu la ti on le ve l su rv ey s Ev er y tw o ye ar s – M IY CN K A P su rv ey s Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 101 Annex 2.6 Nutrition commodities and supply chain management Indicator Numerator/ denominator Measurement/ calculation Source documents Frequency of data collection Proportion of CHVs trained on nutrition packages (module 8) # of CHVs trained on nutrition packages Total # of CHVs # of CHVs trained on nutrition packages dived by Total # of CHVs multiplied by 100 CHS reports and capacity assessment reports Yearly Proportion of counties with a budget line for nutrition commodities and equipment # of counties with a budget line for nutrition commodities and equipment Total # of counties # of counties with a budget line for nutrition commodities and equipment divided by total # of counties multiplied by 100 County Budgets Yearly Proportion of counties with drawing rights at KEMSA for nutrition commodities and equipment Proportion of counties with drawing rights at KEMSA for nutrition commodities and equipment Total # of counties # of counties with drawing rights at KEMSA for nutrition commodities and equipment divided by total # of counties multiplied by 100 Procurement and distribution reports from KEMSA Quarterly/ Yearly Proportion of annual nutrition commodity needs met # of annual nutrition commodity needs met Total number commodity needs # of annual nutrition commodity needs met dived by total number commodity needs multiplied by 100 Distribution reports Monthly Proportion of counties with Nutrition LMIS and inventory Management training conducted # of counties with Nutrition LMIS and inventory Management training conducted Total number of counties # of counties with Nutrition LMIS and inventory Management training conducted divided by Total number of counties multiplied by 100 Training reports Yearly Proportion of Nutrition commodities and equipment meeting minimum quality and safety standards # of Nutrition commodities and equipment meeting minimum quality & safety standards Total of Nutrition commodities & equipment # of Nutrition commodities and equipment meeting minimum quality & safety standards dived by Total of Nutrition commodities & equipment multiplied by 100 Certificates of Analysis Yearly Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022102 Annex 3 Good Practice Template Definition: Good practices are well documented and assessed programming practices that provide evidence of success/impact and which are valuable for replication, scaling up and further study. The practice should have a formal evaluation and evidence of an adoption-diffusion process (piloting/scaling up). The practice should have been replicated in more than one site and generally in different contexts (economic, cultural, partners, etc). Instructions for use: Fill in the following fields with your information. Guidance is provided for the major sections in Italic. Either enter text directly or copy and paste from another document. Category: Good practice Country: your text here Title: your text here Related links: Please provide links to related study, report, evaluation, website that may provide additional information on the good practice. Contact person: Please provide the name, title and e-mail address of a person who can be contacted for any questions regarding this good practice. Issue (Background): Briefly (1-2 paragraphs) describe the initial situation (context) and the problem/ issue which prompted the implementation of this good practice. Strategy and Implementation: Describe in 2-3 paragraphs the strategy and its implementation. This should link to the issue outlined above and highlight the main points of the strategy implemented. Strategies could be regarding to advocacy, participation, gender equity, ownership, capacity building, coordination and partnerships, monitoring and evaluation and replication/scaling up. Progress and Results: In summary (1-2 paragraphs), describe the progress and results validated through evaluations or formal review process. The results can be classified at output, outcome and impact level. Provide quantitative and or qualitative evidence for different aspects (e.g. relevance, effectiveness, efficacity, replicability, sustainability) that are the basis of the good practice. Please also describe factors that enabled or hindered progress (challenges). Good Practice: Please provide 1-2 short paragraphs to describe in summary good practice(s) in the field. This should leave the reader with an overall picture of the practices(s), why they are useful and evidence of value they add to programming. Potential application: Please describe briefly the potential application of this practice to programming beyond the original context. Are there potential applications nationally, regionally, in emergency situations, etc.? What are the issues that need to be considered? Next steps: Describe (1paragraphs) any planned next steps in implementation or any challenges in strategy as a result of this good practice to date. Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 103 Annex 4 Research Proposal Guide Technical Working Group Content Guidance Title page • Research title: clear and concise, should reflect the focus of the study and number of words should not be too many. • Names and titles of principal investigators and affiliated institutions • Logos of institutions Table of contents Updated and include key contents of the chapters. Introduction • Background to the study problem, • Problem statement, • Justification of the study, • Research questions, • Hypothesis, • Broad and specific objectives Literature review Global, regional and specific aspects on existing evidence. Conceptual framework Methodology • Study area, • Study population, • Study design • Sample size determination • Sampling techniques, • Study variables, • Data collection techniques, • Data processing and analysis, • limitations and delimitations, • Operational definition of terms. • Ethical considerations. Annex/additional • Reference • Work plan • Budget Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022104 Annex 5 Monitoring and Evaluation products and Feedback mechanisms Report Purpose Description of the M&E Product Frequency of Production Dissemination/ Feedback Target Audience Responsible Institution Quarterly report Bi-annual report Annual reports Mid-term reports End-Term reports Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 105 Annex 6: Formats for presenting reports for Annual work Plans RESULT AREA/ COHORT OUTPUT PROGRESS COMMENTS Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022106 A n n ex 7 : D et ai le d co st o f M on it or in g an d Ev al ua ti on F ra m ew or k Se ct or al a n d M ul ti s ec to ra l N ut ri ti on In fo rm at io n S ys te m s, L ea rn in g an d R es ea rc h St re n gt he n ed 20 18 2 02 2 K N A P, K ey R es ul t A re a 16 O ut pu ts A ct iv it ie s B ud ge t i n K sh 20 18 20 19 20 20 20 21 20 22 T ot al K sh To ta l U SD O ut pu t 1 6. 1 N ut ri ti on s ec to r pl an s pr og re ss r ev ie w ed 18 .4 9 16 .1 2 23 .7 6 2. 89 58 .2 5 11 9. 50 $ 1 .1 8 A ct iv it y 16 .1 .1 : R ev ie w a nd u pd at e th e K en ya N ut ri ti on M & E fr am ew or k 6. 54 6. 54 13 .0 8 $ 0 .1 3 A ct iv it y 16 .1 .2 : S up po rt d ev el op m en t a nd p ro gr es s re vi ew o f A W Ps an d ot he r m ul ti y ea r pl an s an d po lic ie s 0. 13 0. 13 0. 13 0. 13 0. 13 0. 64 $ 0 .0 1 A ct iv it y 16 .1 .3 : C on du ct q ua rt er ly , a nn ua l, m id t er m a nd e nd te rm re vi ew s/ ev al ua ti on s of th e K N A P an d ta ke c or re ct iv e ac ti on s 15 .8 3 6. 92 21 .1 0 0. 23 49 .0 5 93 .1 1 $ 0 .9 2 A ct iv it y 16 .1 .4 : D ev el op a nd d is se m in at ed a nn ua l r ep or ts 2. 54 2. 54 2. 54 2. 54 2. 54 12 .6 8 $ 0 .1 3 O ut pu t 1 6. 2 St re n gt he n ed N ut ri ti on s ec to r ca pa ci ty in N IS a n d ev id en ce b as ed de ci si on m ak in g 7. 08 27 .5 5 15 .9 8 27 .6 0 33 .7 9 11 2. 00 $ 1 .1 1 A ct iv it y 16 .2 .1 : D ev el op a nd u se a n ut ri ti on m ul ti s ec to ra l n ut ri ti on sc or ed c ar d to m on it or k ey K N A P in di ca to rs q ua rt er ly 1. 51 13 .6 6 13 .6 6 28 .8 2 $ 0 .2 9 A ct iv it y 16 .2 .2 : T ra in o ff ic er s on w eb si te M ai nt en an ce a nd m an ag em en t; q ua lit at iv e re se ar ch m et ho do lo gy ; S M A RT S ur ve y m et ho do lo gy ; I nt eg ra te d Ph as e Cl as si fic at io n fo r ac ut e m al nu tr it io n; N ut ri ti on d at a el em en ts a nd in di ca to rs ; S en ti ne l S ur ve ill an ce E ar ly W ar ni ng S ys te m ; 7. 02 27 .4 7 14 .4 2 13 .8 8 20 .0 7 82 .8 5 $ 0 .8 2 A ct iv it y 16 .2 .3 : R ou ti ne D at a re vi ew a nd fe ed ba ck m ee ti ng s w it h co un ti es 0. 06 0. 06 0. 06 0. 06 0. 06 0. 30 $ 0 .0 0 A ct iv it y 16 .2 .4 : C on du ct M & E Ca pa ci ty N ee ds A ss es sm en t a nd A ct io n Pl an fo r fin di ng s 0. 02 0. 02 $ 0 .0 0 O ut pu t 1 6. 3: Im pr ov ed a cc es s to a n d us e of n ut ri ti on in fo rm at io n to in fo rm pr og ra m m es q ua li ty , a dj us tm en t a n d le ar n in g 41 .8 5 41 .7 9 36 .1 5 36 .1 5 36 .1 5 19 2. 09 $ 1 .9 0 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 107 Se ct or al a n d M ul ti s ec to ra l N ut ri ti on In fo rm at io n S ys te m s, L ea rn in g an d R es ea rc h St re n gt he n ed 20 18 2 02 2 K N A P, K ey R es ul t A re a 16 A ct iv it y 16 .3 .1 : C on du ct n ut ri ti on s it ua ti on a na ly si s, g en er at e in fo rm at io n pr od uc ts , a nd d is se m in at e to a ll le ve ls fo r pl an ni ng a nd re sp on se 17 .8 2 17 .8 2 17 .8 2 17 .8 2 17 .8 2 89 .1 0 $ 0 .8 8 A ct iv it y 16 .3 .2 : U pl oa d nu tr it io n pr od uc ts r ep or ts a nd b ul le ti ns in th e nu tr it io n w eb si te a nd p op ul at io n su rv ey d at ab as e an d do cu m en t b es t pr ac ti ce s an d le ss on s le ar nt in M & E/ N IS 0. 09 0. 09 0. 09 0. 09 0. 09 0. 45 $ 0 .0 0 A ct iv it y 16 .3 .2 : S up po rt d ev el op m en t a nd r ev ie w o f d at a pr ot ec ti on sh ar in g gu id el in es . 17 .8 2 17 .8 2 17 .8 2 17 .8 2 17 .8 2 89 .1 0 $ 0 .8 8 A ct iv it y 16 .3 .2 : D ev el op n ut ri ti on d as hb oa rd s, s co re ca rd s, e le ct ro ni c da ta c ol le ct io n to ol s et c. 1. 17 6. 06 0. 42 0. 42 0. 42 8. 49 $ 0 .0 8 A ct iv it y 16 .3 .2 : S ys te m at ic u ti liz at io n of n ut ri ti on in fo rm at io n to in fo rm p ro gr am m es q ua lit y im pr ov em en t 4. 95 4. 95 $ 0 .0 5 O ut pu t 1 6. 4 St an da rd iz ed a n d ha rm on iz ed n ut ri ti on d at a co ll ec ti on m et ho do lo gi es , m an ag em en t, a n d re po rt in g at a ll le ve ls 0. 88 2. 27 1. 02 0. 63 4. 79 $ 0 .0 5 A ct iv it y 16 .4 .1 : R ev ie w / D ev el op a nd d is se m in at e gu id el in es o n nu tr it io n M & E ba se d on fi el d le ar ni ng e xp er ie nc e an d em er gi ng gl ob al g ui da nc e: N ut ri ti on C ov er ag e G ui de lin e; D Q A G ui de lin e fo r nu tr it io n in di ca to rs ; S en ti ne l S it es D Q A G ui de lin es r ev ie w ed ; M IY CN K A P 0. 50 0. 38 0. 88 $ 0 .0 1 A ct iv it y 16 .4 .2 : R ev ie w /d ev el op F ie ld A ss es sm en t M an ua l; G ui de lin es on C N A P D ev el op m en t; IY CF e a ss es sm en t t oo ls a nd g ui de lin es ; N ut ri ti on K H IS to ol s re vi ew ; S M A RT S ur ve y Q ue st io nn ai re r ev ie w ; K A P Su rv ey Q ue st io nn ai re r ev ie w ; 0. 38 1. 56 0. 36 0. 60 2. 90 $ 0 .0 3 A ct iv it y 16 .4 .3 : P ar ti ci pa te in th e H M IS in di ca to r m an ua l r ev ie w 0. 03 0. 03 0. 06 $ 0 .0 0 A ct iv it y 16 .4 .4 : P ri nt , d is tr ib ut e an d di ss em in at e M O H N ut ri ti on M & E fr am ew or k, to ol s, m an ua ls , a nd g ui de lin es . 0. 30 0. 66 0. 96 $ 0 .0 1 O ut pu t 1 6. 5 Q ua li ty n ut ri ti on d at a ge n er at ed fo r ev id en ce b as ed pr og ra m m es m in g 62 .4 7 62 .4 7 16 7. 47 62 .4 7 61 .9 2 41 6. 80 $ 4 .1 3 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022108 Se ct or al a n d M ul ti s ec to ra l N ut ri ti on In fo rm at io n S ys te m s, L ea rn in g an d R es ea rc h St re n gt he n ed 20 18 2 02 2 K N A P, K ey R es ul t A re a 16 A ct iv it y 16 .5 .1 : C on du ct n ut ri ti on d at a cl in ic s to r ef le ct o n N IS p ro ce ss es , k ey e m er gi ng is su es , l es so ns le ar nt fr om fi el d im pl em en ta ti on a nd ta p in to n at io na l, re gi on al a nd g lo ba l e xp er ts to im pr ov e N IS 0. 66 0. 66 0. 66 0. 66 0. 66 3. 28 $ 0 .0 3 A ct iv it y 16 .5 .2 : C on du ct D at a Q ua lit y A ud it s fo r D H IS , L M IS a nd se nt in el s ur ve ill an ce 1. 67 1. 67 1. 67 1. 67 1. 11 7. 77 $ 0 .0 8 A ct iv it y 16 .5 .3 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 it y m on it or in g du ri ng n ut ri ti on s ur ve ys S M A RT , M IY CN K A P an d Co ve ra ge s ur ve ys 0. 15 0. 15 0. 15 0. 15 0. 15 0. 75 $ 0 .0 1 A ct iv it y 16 .5 .4 : C on du ct In te gr at ed N ut ri ti on S M A RT S ur ve ys , M N IY CN K A P an d co ve ra ge a ss es sm en t 60 .0 0 60 .0 0 16 5. 00 60 .0 0 60 .0 0 40 5. 00 $ 4 .0 1 O ut pu t 1 6. 6 En ha n ce d m ul ti s ec to ra l l in ka ge s re su lt in im pr ov ed n ut ri ti on in fo rm at io n e ff ic ie n ci es a n d co st e ff ec ti ve n es s 11 .4 3 37 .8 5 11 .5 4 11 .4 3 37 .7 6 11 0. 01 $ 1 .0 9 A ct iv it y 16 .6 .1 : H ol d pe ri od ic M ul ti s ec to ra l n ut ri ti on c ol la bo ra ti on TW G m ee ti ng s an d m on it or in g of T W G P la n 0. 64 0. 64 0. 64 0. 64 0. 64 3. 19 $ 0 .0 3 A ct iv it y 16 .6 .2 : S tr en gt he n co nt in ui ty o f N IT W G p ar tn er sh ip w it h st ak eh ol de rs s uc h as N D M A , K N B S, F EW SN ET , M O H H IS . 0. 09 0. 11 0. 20 $ 0 .0 0 A ct iv it y 16 .6 .3 : E nh an ce li nk ag es b et w ee n N IT W G a nd o th er w or ki ng gr ou ps w it hi n th e se ct or s. 10 .5 5 10 .5 5 10 .5 5 10 .5 5 10 .5 5 52 .7 7 $ 0 .5 2 A ct iv it y 16 .6 .4 : P la n/ re vi ew T O R s fo r M & E/ N IS in cl ud in g m on th ly m ee ti ng s an d N IT W G c os te d pl an fo r re so ur ce m ob ili za ti on . 26 .3 3 26 .3 3 52 .6 5 $ 0 .5 2 A ct iv it y 16 .6 .5 : S up po rt th e m ul ti s ec to ra l N ut ri ti on In fo rm at io n Pl at fo rm ( N IP ) fo r im pr ov ed m ul ti s ec to ra l d at a an al ys is , di ss em in at io n an d ut ili za ti on . 0. 24 0. 24 0. 24 0. 24 0. 24 1. 20 $ 0 .0 1 O ut pu t 1 6. 8 En ha n ce d ev id en ce b as ed d ec is io n m ak in g th ro ug h re se ar ch 14 .9 2 9. 36 15 .7 5 14 .0 2 12 .6 6 66 .7 2 $ 0 .6 6 A ct iv it y 16 .7 .1 : D ev el op s tr at eg ic p ar tn er sh ip s an d ne tw or ks in ad dr es si ng n at io na l r es ea rc h ag en da 1. 62 0. 12 1. 74 $ 0 .0 2 A ct iv it y 16 .7 .2 : A dv oc at e fo r re se ar ch p ri or it iz at io n at b ot h na ti on al an d co un ty le ve ls 2. 22 0. 42 7. 26 4. 16 4. 16 18 .2 3 $ 0 .1 8 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022 109 Se ct or al a n d M ul ti s ec to ra l N ut ri ti on In fo rm at io n S ys te m s, L ea rn in g an d R es ea rc h St re n gt he n ed 20 18 2 02 2 K N A P, K ey R es ul t A re a 16 A ct iv it y 16 .7 .3 : A dv oc at e an d st re ng th en fo rm at io n an d co or di na ti on of s ub c om m it te es fo r re se ar ch fo r al l c ou nt ie s $ A ct iv it y 16 .7 .4 : D ev el op c ap ac it y in r es ea rc h m et ho do lo gi es , kn ow le dg e tr an sl at io n an d sy st em et ic r ev ie w p ro ce ss es 4. 48 3. 36 3. 33 4. 46 3. 33 18 .9 6 $ 0 .1 9 A ct iv it y 16 .7 .5 : D is se m in at io n of r es ea rc h fin di ng s 3. 14 2. 90 2. 90 3. 14 2. 90 14 .9 7 $ 0 .1 5 A ct iv it y 16 .7 .6 : S tr en gt he n sy st em at ic r ev ie w o f n ut ri ti on s en si tiv e an d nu tr it io n sp ec ifi c re se ar ch 0. 30 0. 30 $ 0 .0 0 A ct iv it y 16 .7 .7 : 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 , m ee ti ng s 1. 32 1. 32 1. 32 1. 32 1. 32 6. 60 $ 0 .0 7 A ct iv it y 16 .7 .8 : E st ab lis h an e ffe ct iv 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 0. 48 0. 48 $ 0 .0 0 A ct iv it y 16 .7 .9 : K no w le dg e sh ar in g tr ou gh p ub lic at io ns 0. 44 0. 44 0. 44 0. 44 0. 44 2. 22 $ 0 .0 2 A ct iv it y 16 .7 .1 0: E st ab lis hm en t o f r es ea rc h R ep os it or y 1. 22 0. 50 0. 50 0. 50 0. 50 3. 22 $ 0 .0 3 Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022110 Annex 8 List of contributors Name Agency/ Department Veronica Kirogo MoH, Division of Nutrition and Dietetics Dr David Soti MoH, Office of the Director general Leila Akinyi MoH, Division of Nutrition and Dietetics Samuel Murage MoH, Division of Nutrition and Dietetics Lucy W Kinyua MoH, Division of Nutrition and Dietetics Julia Rotich MoH, Division of Nutrition and Dietetics Florence Mugo MoH, Division of Nutrition and Dietetics Caroline Arimi MoH, Division of Nutrition and Dietetics Christine Muthoni Maina MoH, Division of Nutrition and Dietetics Francis Aila MoH, Homa Bay county Bernette Walema Ministry of Education Beatrice Ooko Ministry of Education Boniface Ouko Ministry of Education Jane Wanjiru Njeri MoH, Kiambu county Caroline Owange MoH, Nairobi county Jessica Mbochi MoH, Nairobi county Paul Migwi MOH, Nyandarua county Leah Chelobei MoH, West Pokot county Bertha Ocholla Kenyatta National Hospital Lucy Maina Gathigi UNICEF Kibet Chirchir UNICEF Edward Kutondo UNICEF Sicily Matu UNICEF Susan Jobado UNICEF Tom Amolo UNICEF Sophie Ochola Consultant Elijah Odundo Consultant Mark Murage Gathii Consultant Anthony Mativo Kioko World Vision Kenya Chair NITWG Lilian Kaindi Action Against Hunger - ACF Paul Otieno Action Against Hunger - ACF Brian Asande Feed the Children Rosemary Nyaga Feed the children Leonard Kiriama Kenya Red Cross Society Della Akumu Save the Children Ruth Amamo Save the Children MINISTRY OF HEALTH Kenya Nutrition Monitoring and Evaluation Framework 2018 to 2022