Management Response on: ‘Evaluations of ‘Concern Worldwide 2011 Emergency Response Programme in Ethiopia’.

Evaluation Recommendation 1: Concern should continue to solve supply problem (medicine/RUTF/F100 and F75) during their emergency projects (e.g. supporting logistics, keeping extra RUTF and F75/F100 through contingency planning) it is more important that a structural solution is found as this will benefit the national CMAM programme. Concern should advocate for this in area coordination meetings on nutrition, as well as at the federal level with MoH and DRMFSS and the UN country team.
Management Response 1: Concern Worldwide – Ethiopia has tried its best in the past to address the supply issue by creating a contingency stock of RUTF and allocating fund (from internal and external sources) for the purchase of routine drugs for TSF/OTP/SC programmes. At least one vehicle has been and is assigned in emergency nutrition response projects to assist the transportation of RUTF/F100/F75, usually supplied by UNICEF, from Region/Zone down to Woreda level and from Woreda capitals to the various health institutions. At the planning stage, quantities needed, potential sources and time of delivery are clearly stated in the proposal and communicated to all concerned. Whenever shortage of these supplies is encountered, Concern Worldwide always advocates and alerts UNICEF through various forms and sending reports or letters.
Key action(s) (to be added to as appropriate) / Time frame / Responsible Unit(s)
1.1 Include purchase of medicines as a contingency measure in all emergency nutrition projects / Regularly / Emergency Unit
Evaluation Recommendation 2: The persisting non-responders problem is TSFP needs to be closely monitored in relation to supplies, wrong admissions, and applicability of current weight gain standards for pastoralist children, and especially in relation to the general food security situation.
Management Response 2: Problems of non-responders, wrong admission and weight gain continue to be a challenge in all nutrition projects. With the exception of ‘wrong admission’, which is improper application of the protocol, the problems of failure to respond [non-responder] and not gaining weight are associated not necessarily with the treatment but due to other factors such as illness [HIV, TB], social circumstances of the individual, excessive sharing of the ration etc. Concern Worldwide has mostly kept these within acceptable limits because of quality treatment, continuous investigation of cases through home visits and health education practices. The issue of weight gain standard in pastoral areas not yet resolved as there is no agreement on suitable criteria and indicators among practitioners.
Key action(s) / Time frame / Responsible Unit(s)
2.1 Raise the issue with Federal ENCU and ask their recommendations / During pastoralist emergency meetings / Emergency Unit
Evaluation Recommendation 3: The link between the emergency phase and the return to the national programme EOS/CBN/HEP needs to be strengthened in order to benefit fully from the strengthened outreach system and continue the early identification of MAM and SAM. This should be discussed and carefully planned in learning review meetings at the end of the emergency phase.
Management Response 3: When Concern Worldwide responds in an EOS Woreda (where six monthly screening, deworming and three monthly SF distribution takes place) linkage is created starting from project commencement through admitting all beneficiaries screened by EOS, involvement of food distributing agents and transferring cases between other TSFP and OTP sites. The list of beneficiaries remained at the end of the emergency phase also handed-over to the EOS programme when the emergency response phased-out. The other two components (CBN and HEP) are routine MoH activitie, as part of the health extension package, and Concern Worldwide is not involved in these areas – only get involved when case-loads are beyond the capacity of MoH.
Key action(s) / Time frame / Responsible Unit(s)
3.1 Develop guidelines for linkages between Emergency Programmes and other govt programmes / During preparation of NNP document / Health and Nutrition Unit
Evaluation Recommendation 4: Emergency nutrition projects should integrate, as far as possible principles of recovery, IYCF and WASH.
Management Response 4: Though subject to the size of available funds and to some extent donor policy, IYCF, and WASH activities (such as provision of water treatment chemicals, jericans, soap and education) have become an integral part of the emergency nutrition response projects, particularly in areas where Concern Worldwide has a long-term presence, with the aim of addressing underlying causes contributing to malnutrition. Where possible, Concern Worldwide has implemented recovery projects targeting food insecure households including families with SAM and MAM cases – Delanta and Bugna recovery project, funded by DEC, is a good example.
Key action(s) / Time frame / Responsible Unit(s)
4.1 Link emergency response with development programmes / 2013 / Emergency Unit and other departments
Evaluation Recommendation 5: Recommendations for recovery approach
·  Ideally after each emergency nutrition project a recovery project should implemented
·  Landless should also benefit from livelihood support
·  Priority should be given to those households that do not receive PSNP support
·  Livelihood activities should include income diversification away from agriculture in rain dependent drought stricken areas with unproductive soil like Dessie Zuriya and Delanta. Such activities can also accommodate the landless. Based on situation analysis income generating activities can include: adding value to local production (lentils broken into two half/wool, cleaning, colouring, spinning, weaving or knitting), traditional hand crafts (woodwork, leather or baskets – assist in linking to markets), skills training, micro-projects (fruit and vegetable production, small ruminants, beekeeping, poultry), and simple irrigation methods.
·  Foremost Concern should continue their efforts to learn from recovery projects
·  Simultaneously Concern should advocate for inclusion of recovery in the national emergency nutrition guideline with ENCU and other units within the DRMFSS, as well as in donor platforms
·  The impact of Concern’s recovery projects on livelihood resilience should be documented to support advocacy.
Management Response 5: Management agrees that a recovery project should follow emergency response, which is also indicated in the government’s policies[1]. But, practically impossible in many cases due to funding constraint/lack of commitment from donors’ side and the fact that Concern Worldwide cannot implement recovery programmes in all emergency response areas (too many) again due to capacity and funding issues. As mentioned above, recovery project have been implemented when conditions permit – Delanta and Bugna – and in such cases, the poorest of the poor including landless, the youth and non-PSNP beneficiaries are targeted. Furthermore, Concern Worldwide’s long-term programmes, particularly the Food, Income and Markets (FIM) or the livelihood sector incorporates most of the activities recommended above. Although the learning review exercise that usually takes place at the end of the project period covers or assesses the lessons learnt from all project components, an impact evaluation of recovery projects can be considered.
Key action(s) / Time frame / Responsible Unit(s)
5.1 – Impact evaluation of recovery projects based on funding availability / Mid of 2013 / Emergency Unit

[1] ‘National Policy on Disaster Prevention and Management, October 1993’ and ‘National Policy and Strategy on Disaster Risk Management (draft document), March 2009’.