Aid-oaa-a-00014 Geographic Scope

FANTA-2 works to improve nutrition and food security policies, strategies, and programs through technical support to the United States Agency for International Development (USAID) and its partners, including host country governments, international organizations, and nongovernmental organization implementing partners. Focus areas for technical assistance include maternal and child health and nutrition in development and emergency contexts, HIV and other infectious diseases, and food security and livelihood strengthening. FANTA-2 develops and adapts approaches to support the design and implementation of field programs, while building on field experience to improve and expand the evidence base, methods, and global standards for nutrition and food security programming. The project is managed by FHI 360 and funded by USAID.

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  Provide targeted, specialized technical assistance and training activities to support nutrition and food security programming strategies, early warning and response systems, and monitoring and evaluation (M&E) for Title II and other USG programs.
  
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  Integrate Community-Based Management of Acute Malnutrition (CMAM) into national health systems and strengthen community-based growth promotion (CBGP) and behavior change programs.
  
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  Improve CMAM programming in emergency, reconstruction and stabilization contexts.
  
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  Support national nutrition and HIV policies and guidelines, integrate food and nutrition into PEPFAR HIV services, and strengthen nutrition assessment, counseling, and support (NACS) programming.
  
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  Support quality assurance/quality improvement of CMAM, CBGP and nutrition/HIV programs.
  
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  Support improved nutrition and food security programs in other priority areas as needed.
  

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  Support advances in methods and tools that promote program quality.
  
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  Increase capacity to deliver effective services at scale.
  
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  Strengthen international, USG, country government and implementing partner capacity to design, deliver, monitor, improve and demonstrate effectiveness and impact of USAID-assisted nutrition and food security programs.
  
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  Develop and refine indicators measuring household and individual food security and diet quality.
  
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  Build the evidence-base on the impact of lipid-based nutrient supplements (LNS) on prevention of 1) chronic malnutrition, 2) seasonal increases in acute malnutrition and 3) acute malnutrition in vulnerable, disaster-affected populations, through effectiveness trials in multiple countries.
  
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  Adapt Lot Quality Assurance Sampling (LQAS) approaches for cost-effective M&E.
  
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  Develop methods and tools for quality assurance/quality improvement, beneficiary screening and targeting, and cost analysis for program planning and implementation.
  

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  Centro de Investigaciones en Nutrición y Salud (Guatemala)
  
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  International Food Policy Research Institute (United States)
  
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  National Institute of Nutrition (Vietnam)
  
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  Nutriset (France)
  
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  Population and Environment Services (Madagascar)
  
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  Regional Centre for Quality of Health Care (Uganda)
  
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  Save the Children (United States)
  
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  Social Sectors Development Strategies (United States)
  
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  Tanzania Food and Nutrition Centre (Tanzania)
  
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  Technical Assistance to NGOs International (United States)
  
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  Tufts University (United States)
  
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  University of California at Davis (United States)
  
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  University Research Corporation (United States)
  
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  Valid International (United Kingdom)
  
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  Washington University in St. Louis (United States)
  

Uganda

At the request of USAID/Uganda, FANTA-2 is helping to strengthen maternal and child health and nutrition (MCHN) programming in Uganda, build political interest in MCHN and develop a community-based nutrition program approach to reduce malnutrition among women and children.  The project’s earlier work included providing technical assistance for the nutrition care and support of people living with HIV (PLHIV).  

Uganda National Action Plan 2011-2016: The Government of Uganda has developed a 5year Uganda Nutrition Action Plan (UNAP), a framework for addressing the country’s nutrition issues. The goal of this plan is to improve the nutrition status of all Ugandans, with emphasis on women of reproductive age, young children, and infants. The plan is intended to reduce the magnitude of malnutrition in Uganda and its impact on the individual, the household, the community, and the nation at large. The government also produced a short document targeted at district- and lower-level leaders to raise awareness of the nutrition situation in Uganda and to introduce the UNAP. Read more and download the materials

Nutrition Situation Analysis: To inform development of a community-based approach, FANTA-2 conducted a situation analysis to assess the nutrition problems, causes, activities, challenges and opportunities facing the country. The findings are available in the report, The Analysis of the Nutrition Situation in Uganda. FANTA-2 also is drafting a desk review, which includes FANTA-2’s strategic mapping of the nutrition interventions in Uganda and results from preliminary field work conducted to better understand current nutrition practices, barriers and constraints, and partnerships in nutrition.

Guidelines on Integrated Management of Acute Malnutrition (IMAM): In collaboration with the Ministry of Health (MOH), UNICEF, NuLife and other nutrition stakeholders, FANTA-2 provided technical input to the Uganda Guidelines on IMAM (equivalent to Community-Based Management of Acute Malnutrition) and has developed monitoring and reporting tools for IMAM programs.

Infant and Young Child Feeding (IYCF) Policy Guidelines and Counseling Tools: FANTA-2 has been a key partner in completing the IYCF Policy Guidelines and counseling tools, a process spearheaded by the MOH. Based on evidence from the Uganda Demographic and Health Survey (DHS), FANTA-2 advocated for the guidelines to focus on key IYCF issues that had been overlooked in the draft versions, particularly related to prelacteal feeds and specific complementary feeding issues.

Nutrition-Focused Advocacy Package: FANTA-2, in partnership with WFP/Uganda and UGAN, developed a set of nutrition advocacy package that work to meet the need for harmonized messages to inform Ugandans that nutrition affects all sectors of society and is cross-cutting. The briefs have targeted advocacy messages using data from Uganda PROFILES spreadsheets. PROFILES is a process for nutrition policy analysis and advocacy that uses spreadsheet models to estimate the functional consequences of malnutrition in terms that policy makers understand and care about. In 2010, FANTA-2 worked with partners, including WFP/Uganda, to update the sections of Uganda PROFILES that illustrate the cost of malnutrition in Uganda in terms of productivity, morbidity, and mortality, among other development outcomes, using 2006 Uganda Demographic and Health Survey (DHS) data.

Promising Practices in Nutrition, Food Security and HIV Programming: The Regional Centre for Quality of Health Care (RCQHC) and FANTA reviewed nutrition, food security and HIV programs in Uganda, Kenya, Malawi, Tanzania and Zambia to identify and document promising practices to help understand what works, replicate successful approaches and incorporate lessons into programs. The findings are available in the report, Nutrition, Food Security and HIV: A Compendium of Promising Practices.

Nutrition Care and Support for PLHIV: With support from USAID/Uganda and RCQHC, FANTA provided technical assistance in the development and application of national guidelines on nutrition and HIV/AIDS in Uganda, which were produced by the MOH STD/AIDS Control Programme and the Uganda Action for Nutrition, a national nutrition coalition. Nutritional Care and Support for People Living with HIV/AIDS in Uganda: Guidelines for Service Providers provides recommendations on the nutritional needs of PLHIV and on steps service providers can take to help PLHIV manage symptoms and improve functioning through nutrition actions.

Counseling Materials for PLHIV: RCQHC, FANTA and the LINKAGES project created and revised Counseling Materials for Nutrition Care and Support of People Living with HIV/AIDS for counselors and service providers to support nutrition care and support for PLHIV. The materials include counseling cards on key nutrition actions, a job aid, answers to frequently asked questions about nutrition and HIV/AIDS, a meal planner, a nutrition assessment tool and a fact sheet on healthy eating for PLHIV. The materials,   developed with a focus on Uganda, are being adapted and used in other countries as well.

Agriculture-Based Livelihood Strategies of PLHIV: FANTA worked with a Family Health International (FHI) project,  Regional Outreach Addressing AIDS through Development Strategies (ROADS),  in the border town of Busia, which straddles Uganda and Kenya, to review and document agriculture-based livelihood strategies that HIV-affected households and communities are adopting. FANTA documented results and lessons from the process, including approaches that were effective at strengthening livelihoods, in the report Strengthening Agricultural Technologies Among People Living With HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda. FANTA helped strengthen PLHIV cluster livelihood activities and enhanced their access to new opportunities, including expanding successful livelihood practices to other PLHIV clusters in the ROADS project.

Integrating Essential Nutrition Actions (ENA): FANTA provided technical assistance to UNICEF and RCQHC to integrate ENA--a set of seven interventions that promote nutrition and child survival--into the health sectors in Uganda and Malawi. In Uganda, where the ENA approach was being implemented by the MOH, UNICEF and the A2Z Project, FANTA collaborated A2Z and the Africa 2010 project to revise and update the BASICS ENA district health services checklist. FANTA also helped UNICEF/Uganda design a three-step process to implement ENA and provided guidance and comments on the development of a self-assessment tool (based on the ENA district health services checklist) that UNICEF used to determine technical and coverage gaps in health facilities. FANTA-2 continues to work with partners in Uganda to develop community-based nutrition program approaches based on ENA.