Impact assessment of UN/WFP`s community based milling and fortification in Northern Ghana

Abstract

WFP provides food and nutrition assistance to improve the nutrition and food security of at-risk groups and enable access to basic education for disadvantaged children as well as support for girls’ education. WFP further assists food-insecure populations vulnerable to droughts, floods and high food prices including people living with HIV (PLHIV), through various interventions including school meals, supplementary feeding, income generating activities and Food for Assets. Ghana is a pilot country for the Purchase for Progress (P4P) and Renewed Efforts Against Child Hunger (REACH) initiatives. WFP has been present in Ghana since 1963 and supports 444,400 beneficiaries in 2012. In 2007, WFP initiated, supported and coordinated the implementation of pilot projects for women groups in some communities that participated in the WFP supported supplementary feeding centers. These projects had a two-prong objective of improving the nutritional status of women and children by promoting flour fortification and consumption of iodized salt, and at the same time provide an alternate source of income for the women groups through milling and fortification and re-bagging and sale of iodized salt as a business. The pilot projects had the overarching goal of fighting against micronutrient deficiency while increasing income of women groups in their respective communities. Building on the work of WFP and UNICEF in the area of nutrition, CIDA has provided funding for WFP to implement the “Tackling Malnutrition in Northern Ghana” which aimed at addressing malnutrition and food insecurity in Northern Ghana. As part of this programme, WFP coordinated the scaling up of the community based milling and flour fortification as well as the re-bagging and sale of iodized salt projects in selected communities in Northern Ghana between May 2009 to December 2011. The intervention has had many successes such as increased incomes from sale of fortified flour, better nutrition and increased awareness of the importance of consuming fortified food. As a result, instead of the planned single scale up intervention, the project has seen 3 scale-ups in the duration of the project. In order to realize the full benefit of these intervention programmes, an, impact assessment study was conducted to assess the impact of the earlier interventions aimed at reducing the micronutrient deficiencies by 5% in the scale-up communities in Northern Ghana. Results from this study shows that in general child anthropometry in Upper East region and the usage of iodated salt in Northern and Upper West regions showed some significant impact among all the indicator variables observed. In all the three Northern regions, there was no significant change observed in maternal nutritional status based on BMI classifications and means. However, Child nutritional status (underweight, stunting and wasting) had significantly reduced in Upper East Region as compared with the other regions. The prevalence of stunting had improved in all three regions. Stunting which is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period is improving. There was also a significant decrease in the prevalence of underweight from 18.4% to 12.9% in the Upper East Region. The prevalence of stunting also reduced significantly from 28.4% to 19.3% which showed about 9.1% reduction in stunting prevalence. In the Northern Region, the prevalence of stunting had decreased significantly from -1.86 to -1.69 at 10% confidence level. In the Northern and Upper West regions there has been a significant increase in the usage of iodated salt in this survey than it was observed at baseline. In Upper East however, there was no significant difference between the usage of iodized salt at baseline and at the end line survey. The Northern and Upper East Regions also recorded significant increases in maternal anaemia. However, there was no significant positive impact observed for anaemia prevalence in all the three regions. Apart from iron rich foods, maternal knowledge on micronutrient and nutrition was very poor. The report recommends continuous education on nutrition in handout and manuals, proper infant feeding practices and good hygiene practices to be put in place to help mothers get properly informed about nutrition and health for the entire family. This study also recommends the continued support of women groups in increasing access to and consumption of fortified foods at community and household levels, as it increases their nutritional status as well as their income-generation potential which enables them to further enhance their food and nutrition security