Surafel Mekonnen's (Government of Ethiopia) presentation at the Transfer Project Workshop in Arusha, Tanzania on 3rd April 2019.

1. Surafel Mekonnen
Safety Nets Team of Ministry of Labour and Social
Affairs (MoLSA), Ethiopia
Transfer Workshop, 2 to 4 April 2019
Arusha, Tanzania
The Improved Nutrition through integrated
Basic Social Services and Social Cash Transfer (IN
SCT) Impact Evaluation - Qualitative and
Productive Results

2. Contents:
•Background to the IN SCT
•Objectives and Design of the Impact Evaluation
•Qualitative Results
•Productive Results
•Quantitative Highlights
•Key Takeaways

3. Introduction to the IN-SCT in the framework of
the Productive Safety Net Programme (PSNP)
 4 years pilot intervention in SNNP and Oromia regions funded by
UNICEF and Irish Aid (2014-2018)
 Implemented as additional layer of services in the framework of the
PSNP in its 4th
phase
 The RPSNP as the second largest Safety Net Programme in Africa
Main IN SCT Objectives:
– Reduction of poverty and under nutrition of food insecure
households part of the PSNP
– Increased access to basic social services with focus on MNCH
and Nutrition by fostering co-responsibilities for two client
groups of the PNSP: Permanent Direct Support (PDS) and
Temporary Direct Support (TDS) clients
– TDS clients are pregnant and breastfeeding women and
caretakers of malnourished children temporarily exempted from
the PSNP Pubic Work component

4. Key features of the IN SCT:
 Integrated package of multi-sectoral nutrition services via
client co-responsibilities monitored through Social Workers in
the scope of a comprehensive Case Management System
(monitored through an MIS), including:
 Mobilize behavior change communication (BCC) sessions for
PDS, TDS and PW clients:
Evaluation Objectives
 a set of child-specific nutrition and health-related outcomes
 effectiveness with which it reaches its target group and delivers
outcomes
 the co-responsibilities related to nutrition
 operational linkages and coordination effectiveness for the
system approach of the program

5. Evaluation Design
 Mixed methods evaluation
 Partnership between the GoE, UNICEF, IFPRI, the Institute of
Development Studies at University of Sussex and Cornell University
and FAO.
 Qualitative:
 baseline data collected through structured key informant interviews
conducted in March-April 2016
 midline and end line qualitative interviews conducted in March 2017
and March 2018 respectively
 Quantitative: (baseline data collected between April and June 2016)
 Mother-Child sample: households with pregnant and lactating women
and/or with children of 6-23 months of age
 Under-5 sample: households with at least one child under 5 years of age

6. Qualitative Results: Multi-Sectoral
Collaboration
 Multi-sectoral collaboration in PSNP woredas is facing challenges
(SW&HEW).
 Multi-sectoral collaboration in IN-SCT woredas is working well.
“The co-responsibilities that are implemented well in our Woreda are ANC and
PNC visits, vaccinating children and sending children to school.” [HEW, SNNP]
 Implementation of TDS in PSNP woredas is mixed.
“The transition of pregnant women into TDS is going well.” [HEW-1, SNNP]
“The transition for caregivers of malnourished children into TDS is not going
well.
 Implementation of TDS in IN-SCT woredas is much more effective.
“The transition for pregnant women into TDS is going well. ”
When women feel they are pregnant, they come to us. We confirm their
pregnancy. When they reach the 4th months of their pregnancy, we write a
transfer letter to the DA and the DA will immediately transfer them into TDS.”
[HEW-3, SNNP]

7.  Child nutrition
 “There is positive change because of education from the HEW ,cooking
demonstrations and nutrition club” [PDS, SNNP].
 Malnourished children
 “Currently, there are 12 moderately malnourished children under 5. Only one
of these is from a PSNP household while 11 are non-PSNP.” [HEW, SNNP]
 Implementation of BCC in IN-SCT Woredas is relatively well implemented.
 “I conducted 6 BCC sessions last year and 2 sessions this year for PSNP clients.
Other sessions were done jointly with the DA.” [HEW, Oromia].
Qualitative Results: Co-responsibilities and BCC

8.  Education and Health
o “IN-SCT had a positive impact because we are constantly checking and followingup
on school attendance, it is one of the most important jobs we do.” [SCT, SNNP]
o “Positive change in immunisation of children is due to improved awareness among
women through the BCC sessions, vaccination campaigns and follow up on
co-responsibilities.” [PSNP, Oromia]
 Gender
 Innovations in programme design benefit women more than men (e.g. transition
of pregnant women from Public Works to TDS).
 Women’s empowerment has increased. (“Women have developed a sense of
power in controlling resources and making decisions.” [HEW, Oromia])
 Female-headed households were deliberately targeted.
Qualitative Results: Education and Health

9.  Increase the number of Social Workers
“One Social Worker covering two kebeles with a motor-cycle,
or one Social Worker per kebele without a motor-cycle.” [PSNP, SNNP]
 Strengthen collaboration and reporting between HEWs and SWs
 Strengthen cross-sectoral collaboration, by strengthening the steering
committee at woreda level and ensuring there are monthly meetings
 Integrate child protection in the case management system of IN-SCT, and
build the capacity of Social Workers for case management
 Regular training and refresher training for HEWs, DAs and Social Workers
on rules regarding the transition from PW into TDS for PLW
 Improved data management and sharing regarding PDS and TDS clients
 Complete the development and pre-testing of the MIS before it is rolled out
Qualitative Results: Recommendations

10. Productive Impacts in the sample of households with
pregnant/lactating women and children under 2
-.202
.071
.024
-.507
.164
-.051
-.626
1.774
.108
.377
-.208
.497
.743
.086
.794
.45
1.186
0
HH has plough
Ag extension crops
Ag extension livst
Farmer planted any Teff
Farmer planted any Maize
Farmer planted any Coffee
Total production of Teff
Total production of Maize
Total production of Coffee
HH sold Teff during any seasons
Diversification
Land operated
TLUs
HH sold livst byproducts
Income from lvst byproducts
HH operated NFB
HH has homegarden
-.5 0 .5 1 1.5 2

11. Productive Impacts in the sample of households with
children under 5
-.027
-.046
-.206
.438
-2.316
-.077
1.256
-.184
-.066
-2.306
-.022
-.37
-1.215
.342
.019
-.274
-.075
0
HH has plough
Ag extension crops
Ag extension livst
Farmer planted any Teff
Farmer planted any Maize
Farmer planted any Coffee
Total production of Teff
Total production of Maize
Total production of Coffee
HH sold Teff during any seasons
Diversification
Land operated
TLUs
HH sold livst byproducts
Income from lvst byproducts
HH operated NFB
HH has homegarden
-2 -1 0 1 2

12. Productive Impacts
 Mother-Child sample
Combining cash with access to services leads to positive
productive impacts (crop and livestock sector )
 Under 5 sample
The effects on the production realm of the
combination of cash or public works with access to services
are mostly null except for few reductions (share of maize and
teff growers)
• IN SCT led to meaningful improvements in household dietary
diversity and food security, asset holdings, child schooling and
child protection
• Women in the program learned important nutrition messages
and improved some practices, such as breastfeeding

13. Key Take Aways
• The availability of Social Workers at community level is a key
for the successful implementation of integrated Social Protection
Programmes.
• Adequate Coordination between different stakeholders (e.g.
Social Workers, Health Extension Workers and Development
Agents) with clear roles and responsibility is vital for integrated
Social Protection Programmes
• To ensure tangible Nutrition Impact on children, long term
investment into Cash Plus components is crucial (e.g. in the area
of sustainable agricultural activities)
• An integrated Case Management System supported through
an IT based Management Information System (MIS) enhances
multi-sectoral collaboration (e.g. between social affairs, child
protection, health and nutrition)
• Using existing government and programmes structures ensured
Government Ownership and long-term sustainability of pilot
interventions

14. Social Workers in IN-SCT changed this story

15. Thank you for your attention!