Monitoring and Evaluation (M&E) Systems For Food Security Impact of Food Aid

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Monitoring And Evaluation (M&E) Systems

For Food Security Impact Of Food Aid

Report On A
CARElGuatemala - IMPACT Workshop
Guatemala, November 6-10,1995
Monitoring And Evaluation (M&E) Systems
For Food Security Impact Of Food Aid

Report On A CARElGuatemala - IMPACT Workshop


Guatemala, November 6-10,1995

Anne J. Swindale
Joyce M. King

January 1996

This activity was carried out with support from the United States Agency for International
Development, Bureau for Global Programs, Field Support and Research, Office of Health and
Nutrition under the Food Security and Nutrition Monitoring Project (IMPACT)"with financial
support from the Bureau for Humanitarian Assistance, Office of Program and Policy
Evaluation, Contract No. DAN 5 110-Q-00-0014-00 Delivery Order 11.
1
Table of Contents

Page
1. Summarv of the utilitv of the worksho~for CARE Guatemala
1.1 Background
1.2. November 1995 Workshop
1.3. Next steps for CARE Guatemala
1.4. Evaluation of the workshop
2. Lessons learned from the worksho~
2.1. Data sources for indicators
2.2 Evaluation design methodologies
2.3 Diagnostic versus baseline data information needs
2.4. Indicator selection and definition
3. Worksho~details
3.1. Workshop objectives
3.2. Workshop methodology
3.3. Workshop participants
4. Contextual and methodoloeical presentations
4.1. USAID Food Security and Food Aid Policy -
4.1.1. Introduction
4.1.2. Policy Context
4.2. USAIDtGCAP Logical Framework and Title I1 Program
4.3. Results of LAC HNS Title I1 Cost-Effectiveness Study in Honduras
4.3.1. The Impact of Food Aid and Income Transfers on Health and Nutrition in
Honduras: An evaluation of the Mother-Child Health Cou~onand Food Aid
programs.
4.3.3.1. Results of the evaluation of the Mother-Child Health Coupon and Food
Aid programs in Honduras.
4.3.2. The Impact of School Feeding and Income Transfers on Education in
Honduras.
4.3.2.1. Results of the evaluation of the impact of school feeding and income
transfers on education in Honduras.
4.4. Monitoring and evaluation concepts 16
4.5. Operationalization of Indicators for CARE'S Final and Intermediate 20
Objectives

Appendix 1: Agenda
Appendix 2: List of Participants
Appendix 3: USAID food security conceptual framework
.1. Summan of the utilitv of the worksho~for CARE Guatemala

1.1 Background

CARE Guatemala has understood the need to consolidate its activities for some time.
Consolidation involves the complex task of integrating a variety of programs including MCH,
Food for Work (FFW), agricultural production and community banking under a Food Security
framework. CARE was not yet prepared to develop an M&E system, and only at the close of
the November workshop, appointed a task force to complete the steps needed to reach the
stage of developing an M&E system.

By the time CARE Guatemala presented its 1996 Development Project Proposal (DPP),
USAIDIG-CAP had greatly reduced the size of the geographic area where USAID is willing to
support activities. CARE'S 1996 DPP includes plans for further geographical shrinking and
progressively diminishing numbers of beneficiaries, or clients. USAID had urged, and CARE
also desired, to concentrate activities geographically. Further sources of recommendations for
CARE refocus had come from two recent studies. First, a rapid assessment in four
departments recommended integration of CARE'S program with those of other NGOs; the
creation, solidification and training of nuclei of community leaders; and the positioning of
agriculture as the pivotal point for the program, given the limited access and poor quality of
health services. Second, an MCH evaluation concluded that the project design was deficient in
that the objective of using food as an incentive for increased use of health facilities was
overcome by the greater disincentives of poor accessibility and quality of existing health
services; the evaluation reported, however, improved nutritional status of program children
compared with non-beneficiary children. CARE revised the food as incentive design,
accordingly.

The new 1996 DPP provides for more age targeting and limits on time in program for
households receiving food under the MCH program. However, the program falls short of
achieving a level of project concentration and project complementary that would create the
strongest prospects for ensuring impact on food security. Nevertheless, working within the
food security framework has caused CARE to make a constructive reanalysis of the different
project pieces and their placement in the framework under the appropriate headings of four
objectives: three dimensions of food security--availability, access, and utilization--and a
fourth, ovemding institutional objective of sustainability through community organization. In
the DPP,the intensity of project presence had been inventoried in each administrative division
of the country. This step, however, fails to solve the problem of highly diluted project
resources due to scattered programs within geographical zones working with different
populations (rural MCH,urban sanitation, e.g.). Further, intended institutional strengthening
is frustrated by differences in counterpart levels. The counterpart for the program with by far
the greatest coverage is at the ministerial level while smaller projects that could complement it
are at different lower administrative levels. Thus, CARE recognizes the need for further
internal review of future directions. This difficult evolution probably characterizes most of the
PVOs who took on high-coverage, essentially feeding programs that over time were converted
to MCH, at first in name only. Over the last 10 years, PVOs have tried to transform the
programs by adding nutrition education and growth monitoring/counseling for mothers and/or
health staff training, but they face constraints operating out of health ministries short on funds
and high on staff turnover. Earlier, these MCH feeding programs were run out of the food
distribution sections of PVO offices while smaller technical projects in agriculture, child
survival and sanitation might be run by sector offices of the PVO. The increasing integration
of food with technical projects has been a recent process and has been stepped up by the food
security framework and the more explicit USAID guidelines with respect to integration and
measurable impact .
1.2. November 1995 Workshop

The November 1995 workshop included a review of the new PL480 Title I1 guidelines and had
as primary objectives to develop and/or revise M&E systems for food security and to use the
process of developing guidelines for a specific PVO as the teachingllearning workshop
methodology. Specifically, the week-long effort was to review and refine objectives, and to
review and operationalize indicators for the three major food security dimensions: availability,
access and utilization. It was planned, and turned out to be true, that working this process
would serve as a teaching device for the other attending PVOs and that some of those attending
would bring their own experiences at operationalizing indicators into the process. In addition,
the process of reviewing objectives and indicators helped highlight deficiencies in the design of
CARE's DPP.

Working together during the workshop, the different CARE project -heads increasingly
perceived the inter-relationships (or lack of them) in their food security framework. Some
were only familiar with the section of the DPP pertaining to their program. Thus, gaining an
understanding of what the overarching goals and intermediate objectives should be, and how
they would be measured, for programs that were parts of the food availability, access and
utilization portions was a difficult exercise. What evolved was an awareness by the staff that
CARE's only large-scale program is a maternal health program, that the Title II program is
90% oriented to "health", but that the MCH program had few or no supporting components to
ensure attaining the objective of adequate biological utilization, the evaluation results
notwithstanding. Three days of the workshop were devoted to an attempt at operationalizing
the impactjgoal indicators and the objectives/intermediate effects and sub-objective indicators.
Other attending PVO staff members facilitated and enriched the effort by presenting their own
approaches to the process.

1.3. Next steps for CARE Guatemala

The principal next steps defined by CARE to move forward were: an appointed task force
comprised of sector chiefs and the M&E office would meet regularly to complete several tasks;
review of the Conceptual Framework and of the results in the Rapid Food Security Assessment
Survey to guide necessary program changes; integration of the overall project with the
activities of other organizations; revision of the DPP and the indicators; development of a
detailed implementation plan and M&E system; in support of which technical assistance and
other funding sources would be required. In sum, CARE and different project heads through
the process of indicator revision, saw the need to look again at the separate projects to see how
they contributed, or not, to likely impact on food security. Further it was clear that they
required stronger linkages, consolidation, and integration both within the CARE DPP and with
other PVOs and non-governmental organizations (NGOs) and USAID projects.

1.4. Evaluation of the workshop

The workshop participants were pleased with the apportionment of time, though the oAginal
agenda in fact could not be completed. In retrospect, it was thought to have been too
ambitious, in the light of presenting new concepts to PVO staffs that require considerable
effort to gain "ownership" on their part. Those who benefited most were CARE technical
staff, other PVO technical and management staff from the country and region, World Food
Program and USAID staff members. Unfortunately the workshop was a missed opportunity
for counterpart Ministry staff and CARE management (with the exception of the MCH Sector
chief) who did not attended enough to participate in or profit from the process.

2. Lessons learned from the worksho~

Several issues were discussed in the course of the workshop which may be of interest in
resolving problems faced by PVO elsewhere.

2.1. Data sources for indicators

It was recognized that identifying data sources was a necessary first step prior to the selection
of feasible indicators. Would there be national studies or reports and surveys that would lend
themselves to serving as baseline or annual monitoring in the PVO project areas? Would new
studies have to be budgeted out of PVO resources? Should household food be measured by
availability or by consumption? Should the measurement be an average of household
consumption or be the measurement for the vulnerable members for whom increases are hoped
through project activities? Demographic Health Surveys (DHS) which coincide with baseline
years and are repeated in five year intervals were considered to be potentially useful for
programs with objectives to change or maintain levels of nutritional status in pregnantllactating
(P/L) women and preschool aged children, and to measure certain behaviors practices as they
normally include anthropometric measurements. Increasingly PVO needs should be taken into
consideration prior to the finalization of the DHS design. Project areas could be over-sampled
and a set of questions might be added that would clarify whether the respondent participated in
a Title 11-assisted program thereby dividing respondents into "program" and "control" groups.
In any case, it was thought that DHS data could often serve as baseline even if not 100%
coincidental with project startup.

Household consumption data, on the other hand, are not likely to be available through
national studies, though there might be special studies that might provide complementary
qualitative information. Household consumption surveys would be required to provide
baseline and final data to measure the impact goal of increasing calorie availability in the
household. The studies are expensive but provide high quality data and were considered cost-
effective by the group.

Qualitative information is vital and should complement quantitative data in order to explain
why quantitative data demonstrates the results that it does, and especially to provide the
viewpoints of clients and community leaders. Qualitative data can be collected at the same
time quantitative data are being collected, whether in the form of unstructured questionnaires,
interviews, rapid surveys or observation.

2.2 Evaluation design methodologies

Quantitative information is essential for the credibility of a mid-termlfinal impact study, but it
can be gathered in a variety of ways depending on available human and financial resources,
and the needs of PVO management, donors, government officials or other stakeholders:

a) primary baseline data collected from control and program populations for
comparison with mid-term or final year data from control and program populations for the
highest level of scientific rigor; a control ,group can also be selected at the end of the project,
but the comparison does not prove project attribution because there is no data to indicate the
groups were similarly at project startup.

b) retrospective data from different program populations to permit a comparison of


clients' status upon entrance into the program and after completion of 9 or 12 months;
compiled data from structured questionnaires, interviews and focus groups

In undertaking impact evaluations, which do not have a baseline survey, evaluators have found
that it is difficult to find "uncontaminated" control groups for Title 11-assisted programs where
there are many PVOsfNGOs working in poorest areas.

The way indicators are defined has important implications for evaluation design. There is a
tendency to define indicators in terms of changes in the condition of a particular household or
individual. For example, an indicator of caloric adequacy is defined as " % of households
increasing caloric adequacy by 10%". This definition implies that the same households will be
tracked over time, in other words, that a panel study design is needed. The time, effort and
expense of implementing a panel study design for a project with a 5 year time frame can be
much greater than for a cross-sectional design. If the indicator were defined as " % of
households with greater than 80% caloric adequacy" or "average household caloric adequacy",
a cross-sectional study design could be used.

2.3 Diagnostic versus baseline data information needs

Baseline and problem analysis are often confused. Problem analysis precedes baseline and
identifies the nature and magnitude of the problem and separates causes and effects. In the
process (which includes quantitative and qualitative information, whether from formative
research, participatory community effort, or rapid field surveys), a PVO, often through
brainstorming techniques, takes a decision as to which cause will be attacked in its project(s);
many other causes have to go unattended by the PVO. A baseline survey, on the other hand,
identifies the condition(s) that are to be changed, and takes quantitative measurements that will
be used in a plan or system to evaluate changes in individuals, families, households and
communities.

2.4. Indicator selection and definition

Selecting Indicators for the Impact Goal. The most commonly tried and proved indicator for
measuring the three dimensions of food security is "x percent of households attaining 80-85-90
percent of their requirements". Household surveys provide information on household averages
of food consumption. In this instance the PVO is emphasizing desired change in intra familial
food distribution and vulnerable groups described as children under three years of age and
pregnant/lactating women. Thus, there is need to know more than household averages of
calorie consumption; to have individual assessments of vulnerable household members'
consumption. The latter, however, could not be followed up for impact in a subsequent
household consumption study because the vulnerable members will have changed in five years;
therefore special case studies would be needed to gather the final data on individual changes.
-
The other indicator, change in nutritional status of under-3 or under-5 year old children is
relatively straightforward, with a preference for weight/age because this anthropometric
measure is more useful to the growth monitoring education process, as well as likely to be
more accurately measured under field conditions. Because there are high levels of
malnutrition in the country, it was thought that using both cutoffs at < 2 Standard Deviations
(SD) from standard and < 3 SD might be useful to show more clearly "lives saved".
However, it was noted that the use of two indicators would complicate data analysis, since a
reduction in < 3SD malnutrition would result in an increase in <2 SD malnutrition.

Intermediate Indicator of Food Availability. In searching for a measurement unit to denote


greater household food availability that would result from vegetable gardening, raising small
animals and increasing the production of basic grains, the selected indicator for these "apples
and oranges" was "increase in the market value of the foods available in the householdn.
Defining the indicator in terms of the economic value of the different component provides a
common denominator which will measure the different products produced, irrespective of
whether they are consumed by the household or sold.
Intermediate Indicator of Food Access. The access objective related to a village banking
project. The food access indicator that was selected was the extent to which household income
increased expenditures for foods included in the food basket.

Intermediate Indicator of Food Utilization. The utilization indicator essentially defined


objectives related to food consumption by the most vulnerable family members
@regnant/lactating (P/L) women and small children, and reducing the major cause of food
absorption loss, diarrhea. There was discussion about the validity of making the first indicator
"increasing the percent of women and children who consume more calories" a part of the final
goal with the constraints and potential solutions proposed above.

Food for Work was viewed as primarily significant in terms of infrastructure. Thus if for
sanitation works, the project would fit into utilization rather than availability (commodities) or
access (income). If building roads to markets, it would more aptly fit the food access
objective.

The sustainability objective was untreated. Generally participants felt that there was a paucity
of guidance to indicate whether the question was with respect to institutional sustainability
(building community organizations that would eventually take on responsibilities) or economic
sustainability of activities (cost-recovery). CARE Guatemala treated the sustainability
objective as being achieved by strengthening institutions at all levels; this is in line with
specific guidance in the Food Security Policy Paper.

3. Worksho~details

3.1. Workshop objectives

General:
1) Support Guatemalan CS efforts to develop and review M&E systems for food security
impact
2) Establish guidelines for M&E of CARE/Guatemala1s Food Security and Nutrition
Project (FONUSEP)
3) Increase NGOs, government and other donor involvement: Use workshop to start this
process of closer cooperation, that is called for under reengineering (Objective added at
USAID/G-CAP request)
Specific:
1) Revise and refine CARE'S proposed objectives and indicators for FOMJSEP 1996-
2000, in the context of USAID's Food Security and Food Aid Policy
2) Operationalize FONUSEP's goal and objective level indicators
3) Define the data requirements for indicator measurement and design data collection
instruments
4) Define data collection and analysis methodology
5) Establish guidelines for the design of the baseline study
Workshop is to take advantage of IMPACT support and the experience of other NGOs,
to present a conceptual common ground and reach agreement on a common point of
departure.
Be able to define indicators of success in Aid and Food Security for CARE Guatemala.
It is understood that it will not be possible to complete an evaluation plan in a one week
workshop, but general guideline will be established.
Start to define the indicators and the level of success obtained.
3.2. Workshop methodology

The workshop methodology included lecture presentations, participatory discussion, and


working groups. The final agenda for the workshop is attached in Appendix A.

3.3. Workshop participants

Workshop participants included CAREIGuatemala administrative, field and support staff,


USAID/G-CAP staff, representatives from the Guatemala missions of CRS, SHARE and Feed
the Children; the World Food Program, the Government of Guatemala and the IMPACT
project. A full list of participants is attached in Appendix B.

4. Contextual and methodolonical mesentations

4.1. USAID Food Security and Food Aid Policy

4.1.1. Introduction

Food aid is an important development resource, supporting programs with a range of


development objectives
Food aid activities can have impacts which often go well beyond the immediate
distribution of food supplies to needy people.
For example:
-investments in water conservation efforts, supported by food-for-work programs, have
potential long-term implications for agricultural productivity,
-school feeding programs are intended to improve student attendance and performance,
factors which ultimately lead to enhanced labor productivity and incomes,
-improved health and nutrition achieved through food-assisted maternal and child health
programs or food-for-work efforts at improved water and sanitation have immediate
implications for individual well-being and also promote productivity and income-
earning potential over the long-term.
Sustainable increases in incomes, improved agricultural productivity, improvements in
health and nutrition, and other benefits of food aid programs should ultimately lead to
increases in the availability of food supplies, improved access to food through own production
of food crops, market purchases and other means, as well as the more effective and
appropriate utilization of food to meet human biological needs.

4.1.2. Policy Context

• The concern for demonstrating the food security impacts of Title II food aid programs
is based in U.S. Government policy. Enhancing the food security of the poor in developing
countries is the primary objective of U.S. food aid programs. According to the 1990 U.S.
Agricultural Development and Trade Act:
It is the policy of the United States to use its agricultural productivity to promote the foreign
policy of the United States by enhancing the food securin, of the develovina world through the
use of agricultural commodities and local currencies accruing under the Act to:
combat world hunger and malnutrition and their causes;
promote broad-based, equitable and sustainable development, including agricultural
development;
expand international trade;
develop and expand exportsfor United States agricultural commodities; and
foster and encourage the development of private enterprise and democratic
participation in developing countries.
While U.S. food aid policy emphasizes food security objectives, a 1993 review by the
U.S. General Accounting Office, at the request of the U.S. Congress, found that it was
difficult to document the food security impacts of past food aid programs. According to the
report, this is in part a result of a lack of operational guidance from the Agency to assist in the
identification of food security objectives and evaluation methodologies for food aid programs.
"...it is dzDcult to determine whether food
aid programs promote food security, in part
because USAID has not established a clear policy and operational guidance to assist program
managers in identzjjing food security objectives and evaluation methodologies for food aid
programs. "
In reaction to the GAO report, USAID has taken several steps. A first step was to
develop a food security definition for the Agency: When all people at all times have both
physical and economic access to suflcient food to meet their dietary needs for a productive and
healthy life.
By this definition, food security is a broad and complex concept which is determined
by the interaction of a range of agro-physical, socioeconomic and biological factors. Like the
concepts of health or social welfare, there is no single, direct measure of food security.
However, the complexity of the food security problem can be simplified by focusing on three
distinct, but inter-related dimensions of the concept, all of which are central to the attainment
of food security: food availability, food access and consumption utilization:
Dimensions of Food Security:
Food availability suflcient quantities of food from household production, other
domestic o q u t , commercial imports or food assistance.
Food access: adequate resources to obtain appropriate foods for a nutritious diet,
which depends on income available to the household, on the distribution of income
within the household and on the price of food.
Food un'lization: proper biological use of food, requiring a diet providing suflcient
energy and essential nutrients, potable water and adequate sanitation, as well as
measure on knowledge within the household of food storage and processing techniques,
basic principles of nutrition and proper child care and illness management.
Appendix 3 presents the food security conceptual framework for USAID. highlighting
the three dimensions of availability, access and utilization, the nature of their relationship to
one another, as well as a brief description of their determinants.
Food availability is a function of the combination of domestic food stocks, commercial
food imports, food aid, and domestic food production, as well as the underlying determinants
of each of these factors. Use of the term availability is often confusing, since it can refer to
food supplies available at both the household level and at a more aggregate (regional or
national) level. However, the term is applied most commonly in reference to food supplies at
the regional or national level. PVOs, however, are tending to apply the availability concept to
the issue of the agricultural production of food by the household.
Food access is influenced by the aggregate availability of food through the latter's
impact on supplies in the market and, therefore, on market prices. Appendix 3 indicates that
access is further determined by the ability of households to obtain food from their own
production and stocks, from the market and from other sources. These factors are, in turn,
determined by the resource endowment of the household which defines the set of productive
activities they can pursue in meeting their income and food security objectives.
Food access also is a function of the physical environment, social environment and
policy environment which determine how effectively households are able to utilize their
resources to meet their food security objectives. Drastic changes in these conditions, such as
during periods of drought or social conflict, may seriously disrupt production strategies and
threaten the food access of affected households. To the extent that these shocks often lead to
the loss of livestock and other productive assets, they also have severe implications for the
future productive potential of households and, therefore, their long-term food security.
To cope with those shocks and minimize potential declines in food access, households
typically adjust their consumption patterns and reallocate their resources to activities which are
more insulated from the influence of those shocks. In drought periods, for example,
households may shift their labor resources from crop production to non-farm wage
employment or sell-off small assets to ensure continued income. They may also adjust their
consumption patterns, reducing food intake and relying more on loans or transfers and less on
current crop production and market purchases to meet their immediate food needs. Over time,
as a crisis deepens, household responses become more costly, leading to the loss of productive
assets which can ultimately undermine future livelihoods and long-term food security status.
This corresponds to the component of protection in the livelihood security conceptual
framework of CARE.
Food utilization, which is typically reflected in the nutritional status of an individual,
is determined by the quantity and quality of dietary intake, along with high disease burdens.
Poor infant care and feeding practices, inadequate access to, or the poor quality of, health
services are also major determinants of poor health and nutrition. While important for its own
sake as it directly influences human well-being, improved food utilization also has feedback
effects, through its impact on the health and nutrition of a household members and, therefore,
on labor productivity and household income-earning potential.
In any given context, food security concerns may be due to either inadequate physical
availability of food supplies, poor access among a specific segment of the population, or
inadequate utilization. The conceptual framework in Appendix 3 suggests a hierarchy of
causal factors which ultimately influence the various dimensions of food insecurity: adequate
food availability at the aggregate level is a necessary, although not sufficient, condition to
achieve adequate food access at the household level, which, in turn, is necessary but not
sufficient for adequate food utilization at the individual level.
Another important step in developing an operational policy for the use of food aid by
USAID was the Food Securitv and Food Aid Policy Paper, which stresses the use of food aid
as an instrument for the achievement of food security.
According to Agency policy, the priorities for development food aid programs are:
Programmatic focus:
improving household nutrition, especially for children and mothers;
increasiny agricultural productivity to alleviate one of the leading causes of
hunger; and
increasinp income3 in rural and urban areas through economic and community
development and by promoting sound environmental practices.
Geographic focus:
Sub-Saharan Africa
South Asia
USAID will place particular priority to food aid programs that focus on improving
agricultural productivity and household nutrition in the most food insecure countries,
particularly in Sub-Saharan Africa and South Asia. However, USAID will continue to
approve new food aid activities in other regions of the world and' in other areas of the
program. The program and country priorities are not designed to prescribe arbitrary solutions
to the world's problems, nor to restrict the flexibility of program managers.
As a result of that finding, and in keeping with its mandate to employ performance-
based management methods, the Agency has shifted the oversight focus of food aid programs
from an emphasis on commodity monitoring and accountability, to one which stresses the food
security impacts of food aid programs on their intended beneficiaries. This new management
focus is laid out in the USAID Draft Interim Guidelines for FY 1996 PL 480 Title 11
Develo~mentPro-iect Proposals.
ynM- for results requires the definition of high level objectives that are achievable,
project outputs which support those objectives, and indicators of pe@ormance or achievement.
In the current environment of limited food aid resources, there is a need to focus and
streamline Title ZI development projects in order to demonstrate greater impact and to ensure
that appropriate monitoring and evaluation Vstems are established to document the results of
that impact.
This new focus requires that performance monitoring and evaluation systems be
introduced into Title I1 programs to permit USAID and Cooperating Sponsors to demonstrate
more clearly their programs' food security impacts. Approval for programs will depend upon
the success of field managers in demonstrating that food security impact.
USAlD will change its focus j?om commodity monitoring to a focus on the impacts of
food aid programs. Monitoring and Evaluation fistems will be implemented that permit
USALD and the PVOs to clearly demonstrate the impact that U.S.food aid programs have on
food security.
• Specific elements of the Guidelines include the following requirements for the F Y 1996
DPPs:
An external im~actevaluation of the project must be planned for in the DPP and
conducted no later than thefirst quarter of the final year of the project.
'litle DPP should describe the baseline data utilized and its source, state the
indicators developed for monitoring project-level progress during implementation and
discuss criteriafor assessing impact.
Criteria should be adequate to measure progress in annual reportina and
evaluation and should include benchmarks for activity completion and indicators of
project efectiveness.
The DPP should describe the information and data collection systems in place
or planned that will be used to monitor progress, including data reporting procedures
and mechanisms to analyze the data to direct fiture programming.
The emphasis on performance-based management and demonstrating the impacts of
Title 11 food aid programs on program beneficiaries is an important step forward in USAID
policy. The establishment of effective M&E systems will ultimately improve accountability as
well as program design and management. The information collected by M&E systems should
be of equal or greater importance to the PVOs.
While the guidelines provide clear direction on the role of M&E systems in food aid
programs and Agency decision-making, they leave much to the discretion of program
managers in terms of M&E system design, and offer an important opportunity for PVOs to
influence the definition of feasible and acceptable M&E reporting.
Previously, food aid was viewed as an unlimited resource, subject to impact reporting
and project design requirements that were less rigorous than for projects financed with DA
resources. This is no longer the case. FFP wants to be able to approve well-designed projects
for a five year period.
According to the guidelines, USAID Missions are intended to be close partners in
project planning, monitoring and evaluation and will submit comments annually for each Title
II project. In particular, the DPPs of Cooperating Sponsors, including M&E objectives,
benchmarks and indicators, will be subject to review and concurrence from USAID Missions.
Emphasis has also been placed on the importance of integrating food aid and other resources:
Food aid is most eflective when it is programmed in conjunction with finds for
technical assistance and local currencies for logistical support and grassroots development.
Food aid can also reinforce the positive impact of other development programs such as
nutrition education, family planning, child survival and community development projects.
"Food Aid should be better integrated with the other development resources USAID
programs. "
A DPP will have better possibilities of being approved when it can demonstrate that it
forms part of the USAID Mission's strategy.

4.2. USAID/GCAP Logical Framework and Title I1 Program

Five strategic objectives, by order of priority:


1. Democratization: civil rights and justice system development
-environment and economic growth
2. Improved family health: Smaller, healthier families
3. Natural resource management for sustainable development:
-CARE Guatemala focused more on these activities
4. Trade and labor relations
5. Basic education
Humanitarian assistance, the Food Security Policy of Feb. 1995 - need to develop
principal indicators.
The Mission needs to develop its strategic objectives with community participation
They will take health, and productivity, and human development and combine them in
a single SO, where food aid will be programmed, with the advantage of it being easier to see
food security impact.
• Need to identify indicators that demonstrate the integration of DA and food aid
resources.
Geographic focus of program on the Zona P a . (except El Peten and including San
Marcos). USAID wants to work more in the altiplano and the ex-combative zone.
USAID/G-CAP is pilot mission for reengineering.
-Mission has already developed results package for Health, as part of move to replace
strategic objective framework with result packages.
Important themes for the immediate future:
-Strategies:
-reengineering
-country level
-scarce and decreasing resources (158 million in 1987 to 33 million in 1995,
anticipating at least a 30% cut for 1996).
-food aid represents approximately 30 % of USAID/G-CAP resources.
-Results
-how to define
-less focus on inputs
-less resources means being able to accomplish less.
-how to measure
-at reasonable cost
-the "science of measurement" is very important
-Counterparts
-Government of Guatemala
-Needs to contribute as well. Difficulties foreseen because of loss of
Title1 monetization funds to make counterpart contributions, in addition to the
need to increase level of counterpart funding.
-Clients/partners. Also need to contribute more.
USAIDiG-CAP proposes Title I1 program in Guatemala as a pilot program for
reengineering.
With scarce resources, there is much demand for monetization programs in 1996 to
implement food security programs. Given the level of demand, all proposals must have a
work and activity plan in order for the Mission to calculate the level of support needed.
• Preliminary data for 2 regions (Guatemala City and the South Coast) from the DHS
show improvements.
Use of scarce resources to implement M&E activities. The idea is to have the NGOs
use the results as feedback for their activities.
For the midterm and final evaluations: The point is not to evaluate simply to evaluate.
The point is to evaluate when there is something worth evaluating. This is the norm for dollar
funded projects.
4.3. Results of LAC HNS Title II Cost-Effectiveness Study in Honduras

4.3.1. The Im~actof Food Aid and Income Transfers on Health and Nutrition in Honduras:
An evaluation of the Mother-Child Health Coupon and Food Aid Drograms.

The study compared the cost-effectiveness of three MCH programs implemented in


Honduras:
MCH Income Transfer Program (MCH Bono)
* Distributes a monthly coupon worth 20 lempiras (approximately $2) to children
under 5 years of age and pregnant and lactating women in poor families in poor
regions of the country.
* The beneficiaries can use the coupon to buy food and other products directly
from stores, or they can change the coupon for its cash value in the banks.
* The beneficiaries must comply with a program of visits to the health center in
order to receive the coupon.
MCH Food Ration Program (MCH Rations)
* Distributes a monthly food ration to malnourished children under 5 years of age
and pregnant and lactating women in poor regions of the country.
* The beneficiaries must comply with a program of visits to the health center in
order to receive the ration.
MCH On-Site Feeding Program (MCH Feeding)
* Distributes prepared foods (Morning snack and/or lunch) in community
nutrition centers 6 days a week to children under 5 years of age and pregnant
and lactating women in poor regions of the country.
* The beneficiaries must take turn preparing the food, and contribute
complementary foods such as spices.

4.3.3.1. Results of the evaluation of the Mother-Child Health Coupon and Food Aid
programs in Honduras.

General results:
The MCH Ration program has positive impacts on health service utilization and on
food consumption by beneficiary households, women and children.
The MCH Feeding program has a positive impact on food consumption.
The MCH Bono program demonstrate little evidence of such impacts. It seems to
function more effectively as an income transfer mechanism than as a means to
improve the mothedchild situation.
Specific results:
All the programs are targeted towards the most vulnerable segments of the
population, in terms of level of income and malnutrition.
The programs represent 3 to 10% of household income for beneficiary households
in the bottom quintile.
Participation in the MCH Ration program increases the number of preventative
health center visits.
The quality of health services in the centers that are affiliated with the MCH Bono
and Ratio programs was not worse than in health centers not affiliated with any
program.
Families that participate in the MCH Ration and Feeding programs consume more
calories and protein than families not participating in any program.
Families that participate in the MCH Bono program show no difference in caloric
and protein consumption compared with families not participating in any program.
The two food distribution programs demonstrate a positive impact on caloric and
protein consumption by children under 5 years of age, adolescent girls and women.
The group that participates in the MCH Bono program shows no significant impact
on macronutrient consumption, with the exception of protein consumption by
children under 5 years of age.
The majority of mothers in all sample groups do not know of, or do not practice,
the most important actions that are needed in the areas of maternal health and child
survival. Mothers participating in the MCH Ratio program do have the highest
levels of KAP, and the beneficiaries of the MCH Bonos program have higher levels
of KAP than mothers not affiliated with any program. Although the differences in
KAP that are attributable to the programs are statistically significant, however, they
are small in relation to the desired objectives.
The MCH Bono program is the most cost-effective of the three programs.
• The cost-effectiveness results suggest that, if the principal objective of the programs is
income transfer, then the MCH Bono program is the most cost-effective. If a higher
priority is assigned to mother-child health and nutrition, however, the food distribution
programs, and especially the MCH Ration program, represent the best option.

4.3.2. The Im~actof School feed in^ and Income Transfers on Education in Honduras.
• The study compared the cost-effectiveness of two programs implemented in the schools
of Honduras:
School Income Transfer Program (School Bono)
* Distributes coupons worth 20 lempiras per month (approximately $2) two or
three times a year to the parents of children selected using socioeconomic
criteria.
* The children must be registered and actually attending school in order to receive
the coupon.
• School Snack Program (School Snack)
* Distributes a daily midmorning snack to children in approximately 3,700
primary schools in 9 of the poorest departments.
* The snack provides approximately 20% of daily caloric and 50% of daily .
protein requirements.
* The community makes a substantial contribution, in the form of time, fuel and
money.
4.3.2.1. Results of the evaluation of the impact of school feeding and income transfers
on education in Honduras.

The two programs are targeted more to the rural than urban areas. The School Snack is
distributed throughout the rural areas, while the School Bono program is more targeted
towards the rural west and south (the poorest areas of the country).
The two programs have positive impacts on several variables related to education.
These impacts were observed in all the children in schools with the programs, and not
only in children participating in the program.
The School Bono program impact is greater than the School Snack program for each of
the indicators of effectiveness measured, and four times greater in terms of years
gained, which is a useful summary indicator of education.
The School Snack program increases the rate of advance through school by a quarter
year; the School Bono program increased rate of advance by more than half a year.
The effect of the programs is greater in older children (10-13 years). Children 10-13
years old with access to schools with the Bono program gained almost a year, and older
children with access to schools with the Snack program gained almost a third of a year,
compared with children in schools with neither pragram.
The effects do not vary by sex or poor/nonpoor status of the child.
Neither of the programs has an impact on the probability of a child being registered at
school. This is probably due to the fact that school registration rates in Honduras are
very high (86% of 7-13 year olds are registered).
The School Snack program, and the combined program (schools with both the Bono
and Snack) increase the probability of not repeating the school year. The same effect
is observed with the School Bono program, but to a lesser degree.
The School Bono program has a highly positive impact on school attendance. The
availability of the Bono increased attendance by 6%. The School Snack has no impact
on attendance.
Neither of the programs are associated with systematic differences in academic
performance, as measured by Ministry of Education standardized tests.
Children in households that receive the benefits of the School Snack have higher levels
of adequacy for calories, protein and vitamin A. The snack does not substitute for
meals at home. Dietary adequacy is not higher for children in households that receive
the School Bono.
Neither the School Bono nor the School Snack program have the capacity, with the
current design, to overcome alone all the factors that negatively influence rates of
school registration, attendance and academic performance. Important needs still
remain; some of which can be addressed by the school systems while others depend on
the attention focused on some fundamental economic problems.
4.4. Monitoring and evaIuation concepts

Review of 1996 DPP Guideline requirements for monitoring and evaluation


-Final evaluation
-Baseline data
-M&E system
Program component terminology:
Inputs~Process~Products~Intermediate Effects3Final Impact
The Returns to Information: What are the benefits of M&E information access?
Decision-makers1Stakeholdersin M&E Information Systems
An effective information system supports decisions an actions taken at all levels
within the program
The Uses of M&E Systems
Types of M&E Information:
Needs Assessments: Problem Analyses carried out as formative research,
participatory community analyses, rapid assessment surveys, to complete an analysis of needs;
Conceptualization and Design Analysis. Determine priority areas of PVO
involvement, identify problems, causes and effects, and take decisions on which of the causes
the NGO project (s) will attempt to alleviate.
Efficiency (Cost) Evaluations: examine whether the best use is being made of
available resources, whether costs can be reduced or benefits extended for the same cost and
whether the program is financially viable and sustainable. Questions answered by efficiency
evaluations: 1) What are the costs to deliver services to program participants? and 2) Is the
program an efficient use of resources as compared to alternative allocations?
Program Monitoring (Focus of this M&E Workshop)
Impact Evaluations (Focus of this M&E Workshop)
Program Monitoring:
-establishes that program inputs, activities and outputs have occurred (Were the funds,
foods, and Technical Assistance (TA) available as Programmed? Have the foods been
distributed? Have mothers received their nutritionfhealth classes? Have supervision visits
been carried out with the planned frequency and thoroughness?
-monitors program costs (How much does it cost to deliver x amount of food and
program units to familieslindividuals?)
-tracks progress over time in the access to, and quality of, services by beneficiaries (Is
the program reaching increasingly larger number of clients as planned? And do the services
offered reach more clients and have the content and quality of delivery improved as
programmed?)
-tracks progress in terms of expected impacts of the program on the behavior and well-
being of clients? (Do the clients consume more foods that are rich in Vitamin A? Do mothers
with preschool aged children receive 2 injections of tetanus toxoid? How long do mothers
practice exclusive breast-feeding? -- intermediate effects
-is useful for improved management, administration, and verification of
responsibilities, and as an initial basis for assessing impacts (Monitoring can not only improve
how the flow of services works and the appropriate use of human resources, checking out staff
assignments and responsibilities, but provides information on individuals or samples of
populations with respect to changes that are occurring in behavior, attitudes, practices, health
status, improved access to potable water and to markets (sanitation and roads) (Final results)
• Impact Evaluation
-Impact evaluations gauge the extent to which a program causes change in behavior
and well-being at the population level.
-Monitoring notes only if changes have occurred.
-The assessment of impact necessarily implies attribution of population impacts to
program outputs.
-Impacts may be the result of external factors; which are contained in the total
impact results and must be separated out to leave only those impacts that are attributable to the
program; there should also be a logical linkage from inputs and outputs to intermediate and
final results.
-Impact evaluations are useful in assessing the effectiveness of programs, their
relevance to the issues of concern and in future program design.
-Evaluations not only show measurable results, but indicate whether the project
components were appropriate for the problem posed, and suggest how the project should be
reshaped or refined.
• Questions that are Answered with an Impact Evaluation
-Is the program effective in achieving its intended goals?
-Was the level of severe and moderate malnutrition reduced by 40 percent in the
target population?; Was the prevalence of diarrhea reduced by 30 percent in the households
with preschool aged children?
-Can the results be explained by some alternative process that dws not include the
program?
-Was there an exceptionally good harvest over the last few years that might
explain why the nutritional status of &preschool
l aged children improved? Or was there an
upward swing in the GDP that would have caused the same improvement?
-Is there a link between impact at the population level and the activities of the program?
-Is it likely that the quantity of foods delivered, the quality and number of
education sessions received by mothers and the reinforcing messages on the radio were
sufficient to cause the improvements in the nutrition status of children under three years old?:
-If program components were not present in the magnitude and quality
expected, there can be two answers: 1) a lesser level of inputs/outputs may be required for the
desired impact or 2) the impact was the result of causes outside the program.
• Focus on Im~act.
- Analysis of Impact suggests a focus on changes at the population level, rather than
the program level, than be attributed to program activities.
-Gross Outcome = all measured changes in an outcome indicator
-This might be the cross-sectional or longitudinal data on the program
group which did not have a control group.
-In a program, or intervention, designed to promote oral rehydration
therapy and early recognition and referral, there is a reduction in diarrheal prevalence of 50
percent; however another NGO in the same area has undertaken an extensive sanitation
program which complements the project activities but is responsible for removing a major
cause of diarrhea. The measurement obtained is thus a gross outcome from which must be
isolated the effects of the intervention being evaluated.
-Impact of intervention (net outcome), the change which can be attributed to the
program intervention
-Which part of the reduction in diarrheal prevalence can be attributed to
the program. If possible, the evaluators would try to find an "uncontaminated" area to use as
a control group.
-Effects of Other Confounding Factors. Attribution is a very difficult and
important element in evaluation. Efforts are often frustrated because it is impossible to find a
control group (which must have similar characteristics to those of the intervention group. The
control group does not receive services under the intervention nor from similar projects. In
order to control for intervening external effects, baseline data must be taken on this similar
population at the time baseline is taken on the intervention group to ensure that initial status is
the same. Later during impact evaluation, changes that have occurred in the two groups will
isolate the effects of the program. Less rigorous and also less costly is comparing different
groups of clients within the program: those who have just entered the program, for example,
and those who have been in the program for 9 to 12 months or whatever minimal period is
considered necessary for the program to produce changes in the clients' well-being. This is
sometimes referred to as a statistical control.
Components of M&E Strategy
Selection of measurable program goals. Program goals that can be measured
quantitatively, that specify the change that is hoped for, based on the baseline status of the
target population at the outset of the intervention.
-In an intervention designed to increase food availability, access, and utilization,
two measurable goals are: households that have a sufficient number of calories to meet 80-90
percent of requirements; and nutrition status of under three year old children. They can be
measured with household consumption and anthropometric surveys.
Clearlv specified M&E Objectives
-for example, increase average household food availability (by food type or by
market value of different foods) by x percent over x project years; increase percent of
households with access to potable water; increase length of birth intervals by x months; reduce
prevalence of children growth faltering; reduce percent of moderate or severely underweight
children under x age; percent of target population regularly consuming Vitamin A
supplements.
o Program linked to conceptual framework. The design of the project is realistic
and rational (inputs and outputs lead to outcomes and impact); the linkages within the
conceptual framework permit seeing all of the causes of the problem and the role the project is
expected to play. By establishing plausibility of relationships between what may be called
process indicators--resource availability, agricultural productivity and income-earning potential
that ultimately influence levels and quality of food consumption--and outcome indicators that
measure changes in food consumption, food expenditure and nutritional status, e.g., the
framework strengthens data interpretation.
Cost-effective information system The M&E system should be as simple as
possible and limited in data volume, but sufficient for annual reporting not only of outputs at
the program level, but of changes occurring at the population level. Systems should take
advantage of national and regional data such as ministry-maintained statistics on agriculture,
health and education and of special surveys such as the demographic household studies (DHS),
household consumption and nutritional status surveys.
Operational Indicators Operationalizing indicators requires establishing
the procedures for how to measure the factor or behavior of interest and the criteria for how it
is to be interpreted. Some food security measurements are: dietary intake, food expenditure
levels and nutritional status. Example: Nutritional status may be measured for under-2, under-
3, or under-5 population groups, using mid-upper arm circumference, weight-height, weight-
age or height-age methods. The criteria would be the appropriate cutoff point to use. The
project might hope to reduce rates of malnutrition defined as < 2 standard deviations weight-
age, e.g.1
A focused analvsis plan. The plan should indicate which key questions
the data will answer at all project levels.
Achievable imvlementation strategy. The M&E strategy must be
feasible with respect to resources and needs; depending on needs of program managers, donors
and other key stakeholders, decisions must be made about the amount of data and the
frequency of collection that can be carried out and the extent of scientific rigor required.
Characteristics of Monitoring and Evaluation
Examples: Products--tons of foods delivered, health promoters trained, number of
infrastructure units constructed; which group? Usually all clients; Intermediate Effects-
changes in clients' well-being such as reduced rates of diarrhea, increased availability of food
at the household level, which group? Sample of clients; Final impact--change in nutritional
status, change in mortalityfmorbidity, change in household food consumption, which group?
A sampling of client (and control) population.
Complementary Between Monitoring and Evaluation. Note that monitoring focuses not
only on inputs, process outputs, work plans but also on intermediate egects.
o Types of Data Uses, and Collection Methods for Different Evaluation Focuses.
Preparing for Performance Measurement
Indicator Criteria
-Direct. "Direct" means that the an indicator should be selected which will measure
progress at the level intended whether goal, objective, subobjective or product level.
Example: "persons trained" would be appropriate for the product level but would be
inappropriate (at a lower level) for an objective level such as "improved management";
"reduction of mortality" would be inappropriate at any level except that of the final goal. As
earlier noted, indicators for products are at the program level, while indicators for
objectives/subobjectives representing intermediate effects are almost always at the population
level; indicators for the final goal are always at the population level.)
-0biective. Goal indicators of changes in mortality, morbidity, changes in nutritional
status are commonly accepted in the international health community and the indicators at the
intermediate effect level in the area of child survival have been more tested and well-known
such as expectations for changed patterns of behavior on the part of educated mothers, while
these are less universally applied for food availability and access. An objective indicator is
one that has meaning for most people and is acceptable by both proponents and skeptics of a
program.)
-Available. The choice of the indicator should take into consideration the availability
of data to meet reporting requirements. Particularly demanding is the requirement for annual
information on program performance. Either this information must be collected from
population samples or data might be obtained from periodic surveys, such as contraceptive
prevalence surveys, nutrition surveys or Demographic Health Surveys or from annual Ministry
reports on education, health and agriculture.
-Practical. Self-explanatory.
-Uni-dimensional. If more than one indicator is considered, thought should be given to
the relationship between the indicators so that the results are not likely to be conflicting.
Examples: 1) if one indicator is reducing malnutrition of under-3 children with weight-age < 2
Standard Deviations and the other is reducing malnutrition of under-3 children with weight-age
< 3 Standard deviations, a downward change in the latter would likely result in an upward
change in the former; 2) if one indicator is the prevalence of breast-feeding initiation and the
second is mean duration of breast-feeding, the two indicators complement each other rather
than confuse.)
-0uantitative. Quantitative data is expected at the program outcome and final impact
levels and should be expressed in ratios or percentages rather than absolute numbers.
However, for some objectives, such as democratization, qualitative information in the form of
a rating scale may be required for reporting. In all cages, qualitative information provides
opinions not otherwise available and permits an explanation of results obtained and the
adequacy of the process.
-Disaggregated. The indicator should measure the changes at the level of the
population that is most relevant given program coverage.

4.5. Operationalization of Indicators for CARE'S Final and Intermediate Objectives

Workshop participants in a plenary session attempted to arrive at a consensus for


operationalizing the two indicators for the final food security project goal. Then, in three
workshops different groups analyzed the components of the ongoing programs and existing
problems to arrive at revised intermediate objectives and subobjectives and operationalized
indicators for the three objectives of improving food availability, access and utilization.

Final Goal: To improve the food security of the most vulnerable populations in a
manner that is sustainable after project completion.

1. Percent of households that consume 85 percent of their caloric requirements.

2a. Reduce moderate malnutrition (< 2 Standard Deviations from the Harvard
standard for weight for age) of children under five years of age by x percent.

2b. Reduce severe malnutrition ( < 3 Standard Deviations from the standard for
weight for age of children under five years of age by x percent.
(The percentage of change will be depend on baseline results--what household (and
child and vulnerable mother) the based on the results of baseline survey to measure
food in the household (and for child and woman) and anthropometry (weight and
height) all measures.)

Intermediate Goals and Indicators:

Intermediate Goal 1. Increase the availability of staple foods and key sources of
vitamins and minerals in the most vulnerable households.

Indicator: Percent of increase in the economic return value(*) of production.


(*market value of production, whether consumed or sold).

Intermediate Goal 2. Increase food access of highly food insecure households.

Indicator: Percent of households that increase expenditures for foods from the basic
food basket.

Intermediate Goal 3. Improve the biological ~ t i l i ~ of


o nfood by the project's
target population

Indicators: 1) Percent of P/L women and children under five years of age who
increase their caloric consumption by x* percentage (*to be
operationalized when baseline data from the home consumption survey
are available) N.B., It was thought that this indicator might be moved
up to the Final Goal level.

2) Percent of decrease in diarrhea prevalence in households with under


five Year old children.

Intermediate Goal 4. NOT REVIEWED DURING THE WORKSHOP.

Strengthen national, regional and community institutions' capacity to


manage resources dedicated to obtaining and maintaining food security in
a manner that is sustainable after project completion.
Appendix 1: Workshop Agenda

MONITORING AND EVALUATION (M&E) SYSTEMS


FOR FOOD SECURITY IMPACT OF FOOD AID

CAREJGUATEMALA - IMPACT WORKSHOP


NOVEMBER 6- 10, 1995

November 6

Time Activity Responsible


8:30 Welcome CAREIG:
Salvador Baldidn
9:00 Workshop objectives CARE/G:
Isabel Nieves
9:30 USAID Food Security and Food Aid Policy: IMPACT:
Food aid programming priorities Anne Swindale
Interim Title I1 DPP guidelines
10:30 Coffee break
10:45 USAIDIG-CAP Logical Framework, Title I1 program and Reengineering US ATDIG-CAP:
Margaret Kromhout
11:30 Results of the LAC HNS Title I1 Cost-Effectiveness Study in Honduras Anne Swindale
12:00 Food security framework and principal activities of FONUSEP Borys Chinchilla
Mother-Child Health (MCH)
12:30 Lunch
1:30 Food security framework and principal activities of FONUSEP Carlos Piedrasanta
Agriculture and Family Health (PANUFAM) Gustavo Hernhdez
Urban environmental sanitation (PROSANA) Mynor Corzo
Income generation (Community Banks)
3:00 Food security framework and principal activities of SHARE Guatemala Byron Flores
3:30 Coffee break
3:45 Food security framework and principal activities of CRS Guatemala Luis Alonzo
4: 15 Food security framework and principal activities of Feed the Children Guatemala Efrain de 10s Rios
4:45 Food security framework and principal activities of CARWHonduras Gloria Mamanares
November 7

Time Activity Responsible


8:30 M&E concepts in the context of CS needs and USAID requirements IMPACT:
Food security monitoring requirements Joyce h g
Food security evaluation requirements
Evaluation strategies
Baseline and h a 1 evaluation
Qualitative evaluation
10:30 Coffee break
10:45 Qualitative methods Isabel Nieves
M&E concepts in the context of CS needs and USAID requirements cont. Joyce King
1215 Lunch
1: 15 Food security M&E: CARE Honduras experience Georgina O'Conner
2:00 Community based M&E: SHARE Guatemala experience Byron Flores
3:00 Coffee break
3: 15 Review of FONUSEP goals and objectives Anne Swindale
Final goal: discussion and review of proposed indicators
Operative definition of indicators

November 8

Time Activity Responsible


8:30 Review of FONUSEP goals and objectives (cont.) Anne Swindale
10:30 Coffee break
10:45 Presentation of working group methodology Anne Swindale
11:45 Intermediate goals: discussion and review of proposed objectives and indicators Anne Swindale
Availability: objectives and indicators
Access: objectives and indicators
Utilization: objectives and indicators
12:30 Lunch
1:30 Working groups (by food security component: availability, access, utilization): Facilitators:
Indicator review and definition Swindale, King and
Nieves
3:30 Coffee break
3:45 Continue working groups Swindale, King and
Nieves
November 9

Time Activity Responsible


8:30 Continue working groups: Operationalization of indicators Swindale, King
and Nieves
10:W Coffee break
10: 15 Continue working groups Swindale, King
and Nieves
12:15 Lunch
1:15 Continue working groups: Variable definition and identification of data needs to Swindale, King
measure each component's indicators and Nieves
3: 15 Coffee break
3:30 Plenary Report from Working Group 3: Utilization Liliana de ChAvez

November 10

Time Activity Responsible


8:30 Plenary Report from Working Group 2: Access Clara Aurora Garcia
la30 Coffee break
11:oo Plenary Report from Working Group I: Availability Carlos Piedrasanta
12:30 Lunch
1:30 Plenary Report from Working Group 1: Availability (cont.). Carlos Piedrasanta
2:oo Next steps for CARE Guatemala
2:30 Workshop evaluation
3:oo Close
Appendix 2: Workshop participants

USAIDIG-CAP Government of Guatemala


Program Office Ministrv of Health
Margaret Kromhout Alma Aida Hemhndez
Julia Maria Hussa SEGEPLAN
Ma. Elena Blanco
CARE Guatemala
Propramming Unit IMPACT Project
Salvador Baldiz6n Anne Swindale
Isabel Nieves Joyce King
Health Sector
Dumana Brahman Mendez-England
Borys Chinchilla Stephanie Campbell
Liliana ChAvez
Agriculture and Environment Sector
Carlos Piedrasanta
Luis Moreira
Clara Aurora Garcia
Water and Sanitation Sector
Dora Arriola
Gustavo Hernhdez
Microenterprise Sector
Mynor Corzo
Logistic s u ~ m r t
Ana Lesbia Tecdn
Elena Pinillos

SHARE Guatemala
Byron Flores

CRS Guatemala
Kristen Sample
Luis Alonzo

Feed the Children Guatemala


Joel Reyes
Efrain de 10s Rios

CARE Honduras
Gloria Manzanares
Georigina 0'Conner

World Food Program


Duelio Pkrez
Diagram 2. ~ o o d
Security Conceptual Framework
I

I Social Environment

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