A strong recommendation of the 1992 FAO/WHO International Conference on Nutrition was that each country should develop and implement a national plan of action on nutrition. Most countries now undertake a range of nutrition activities to tackle their nutrition problems. In some cases, these activities form a cohesive national nutrition programme. In other cases, nutrition problems are tackled through a number of focused nutrition projects or programmes, addressing one or more specific nutrition problems, geographic areas or vulnerable groups. Many countries also have externally-funded programmes of varying dimensions and scope.
The nutritional well-being of a population is both an outcome and an indicator of national development. The achievement of national goals depends upon it.
Reducing food insecurity and improving nutrition have recently acquired importance within the context of poverty reduction strategies. We are seeing now an increased scrutiny by donors (and national governments) on the progressive realization of access to food and good nutrition as a human right. Such an environment makes it imperative that food and nutrition programmes succeed and that success is sustained. This is why countries need to undertake assessments of their programmes, to improve outcomes, cost-effectiveness, efficiency and sustainability.
The purpose of this assessment tool is to contribute to strengthening community-based food and nutrition programmes. It is based on a clear, step-by-step analysis of the programme's design and its macro and microenvironments, bearing in mind the programme's likely sustainability.
Use of the tool for nutrition programme assessment is expected to contribute to strengthening macro-micro linkages for the purpose of policy formulation and resource allocation, to forging partnerships and alliances between government, civil society and the private commercial sector and to encourage participatory development within the context of decentralized administrative structures.
The assessment tool is perhaps best suited for longer programmes, of at least two years’ duration. It is ideal for continuous national nutrition programmes which allow time for regular assessments and programme revisions.
The tool makes suggestions for action following assessment.
The suggestions are necessarily limited in scope and specificity because any remedial action must be considered in the national context and will vary from one situation to the next. The assessment itself will suggest ways in which the programme's effectiveness can be improved and, hence, its impact on the nutritional status of its target population.
Assessments can be undertaken at different points in the life of a programme. After completing the first assessment, we recommend that you set a date for the next assessment, allowing time for the actions suggested by the first assessment to be implemented and to be effective. Situations and conditions change, and by undertaking regular assessments, you will ensure that the programme accommodates and responds to these changes.
If you are beginning the process of designing a new programme, we urge you to read the assessment tool so as to ensure that the programme's design incorporates the essential elements needed for it to have a positive impact.
The tool is intended for use by nutrition programme planners, but in collaboration with a number of key people: it is not intended for use by an individual, but rather by an Assessment Team.
A point that needs to be clear also is that it is not a tool for programme evaluation. While there may be some overlap with evaluation, in the area of programme design features, assessment is much broader than evaluation: it examines also the macro and microenvironment within which the programme functions and assesses likely sustainability.
The tool makes every effort to present the methodology of programme assessment in a straightforward and concise way, and in as user-friendly a fashion as possible.
Programme assessment is a complex procedure and over-simplification can lead to errors in conclusions reached and omission of key information. Assessment is not a rapid exercise: it entails numerous discussions and meetings, examination of documents, field visits and observation. But the process itself, as well the ultimate findings, should prove illuminating and will not only serve to improve the nutritional impact of the programme under consideration, but will also lead to better programme planning in the future. Programme assessment should be seen as a continuous and participatory process: it is not a one-off event. But having completed the first assessment, subsequent assessments will prove much easier.
The nature and causes of nutrition problems differ from country to country, as do political, economic and sociocultural environments. Moreover, within a country there may be regional differences. No single assessment tool can accommodate all these differences. Not all the questions this assessment tool asks you to answer will be appropriate for your programme and your country and there may be some other questions that should be asked. We urge you to add or remove questions where necessary. You may also want to prioritize the questions to reflect the particular circumstances of your country or programme. This process of “customizing” the tool is an important part of the assessment process.
The ultimate objective of the tool is to help you launch and develop a process to strengthen your country's ability to address the causes of malnutrition, a complex process that encompasses the promotion of communities’ capacity for self-reliance on the one hand, and real political commitment and support on the other. Nutrition serves as an entry point and nutritional status as the chief indicator that is able to show insufficient or inadequate progress in meeting basic physiological needs, as the first step towards development. To achieve nutritional well-being and full functional and productive capacity in a population, we need to address not simply the immediate causes of malnutrition, namely an inadequate diet and high morbidity, but also their underlying and basic factors. This is illustrated in the conceptual framework provided in Annex 3.