Somalia Multisectoral Nutrition strategy (SMNS)
Goal To reduce malnutrition through direct Maternal and Child Health Nutrition ( MCHN) interventions and indirectly through nutrition- sensitive interventions that reduce poverty and food insecurity.
Expected Impact • Contribute to improved nutrition outcomes especially in the first 1,000 days of life and in early childhood up to 5 years of age. • Decrease the proportion of under five children who are stunted from 12 percent to 7 percent. • Decrease wasting to below 15 % WHO emergency levels; • More than half of the under-five will be consuming the minimum acceptable diet.
Objectives: Somalia Multisectoral Nutrition Strategy (SMNS)
SMNS Objectives. • To create an enabling policy and legal environment necessary for improvement of nutrition outcomes across all the sectors both at national and sub national level • To create, strengthen and sustain sectoral and Multi-Sectoral Nutrition coordination mechanisms at national and sub-national levels. • To improve and strengthen human resource capacity for providing appropriate support to maternal and child nutrition at national and sub- national levels. • To develop and integrate a full package of nutrition-specific interventions into basic health care services at national and sub-national levels
SMNS Objectives. • To improve policy and practises that enhance maternal and child nutritional status through optimal use of nutrition-sensitive services. • To address gender and social-cultural factors that hinder improvement of maternal, infant, and young child nutrition at national and sub national level. • To strengthen organisational, institutional and policy framework for linking humanitarian relief, to recovery and development towards to nutrition improvement at national and sub national level.
Context and process
What is costing useful for? • Assessing efficiency in two “equivalent” programs • Identifying important cost issues for potential savings. • Strategic planning and budgeting for programmes • Together, costing and budgeting helps the planning process by ensuring that the goals are financially affordable. • Benchmarking and Cost recovery
Why operationalise it? • SMSN a tool multi-sectoral cooperation and coordination's for improved nutrition outcomes in Somalia • Essential to estimate the total resource requirement for implementation • Guide contextualized implementation planning • See whole of nutrition programming at a glance • Compliment Monitoring & Evaluation and accountability framework • Facilitate domestic resources mobilisation • Identify gap and guide future investment
Costing Objectives 1. Facilitate costing of the intervention areas identified within SMSN 2. Develop a simple financial tracking and resource mobilization framework for the SMSN- Resource Availability & Gaps 3. Develop prioritized investment scenarios [simulations] to provide funding or priority choices-funding uncertainities: a) Funding above the current financing level: High funding performance scenario b) Current funding basket; if the status quo remains: Current funding scenario c) Funding below current financing level: Least performance scenario
Methodology • Three approaches 1. Analytical Approach: Input-data modelling [ABC Approach] • Analytical approaches: Modelling of cause-and-effect relations • Use of bottom-up approach ;an input- based • Participatory approaches: Involving stakeholders • Costing of all inputs required to achieve Strategic plan targets • Knowledge management: collection and processing of data
Methodology Cont … 2. Stakeholder Engagement • Source: Government and non- government actors • Inclusive & participatory approaches • 4. Data Analysis & Modelling Government, UN agencies, CSOs • Desk reviews from published documents • Budget allocations and projections trends • Methods: KIIs, workshops, resource and patterns/analysis tracking & review of secondary data 5. Dissemination 3. Resource Tracking & Input Costing • Inclusive review and feedback • Estimating resources available based on • Adoption as an advocacy tool budget and budgets projections
Costing perspective • Patient perspective • The patient only or the patient and care-giver • Also known as patient or consumer costs • Health system (Provider) perspective • The health system only • Easy to get data • Also known as provider costs or health system costs. • Societal perspective • Costs to the society • The patient, health system and any other relevant individuals/entities • Broad; puts all costs together from different aspects of society that would benefit
Cost concepts • Incremental costs Additional costs arising from change in decision • Micro based costing Bottom up approach based on the theory of change.
ABC Steps in summary • Identify activities • Determine inputs for each activity • Determine cost for each inputs • Determine cost drivers • Collect activity data • Calculate product cost
Challenges • Resource tracking and Mobilization among partners, donors and other multi-sectoral actors • Alignment and identification of proposed activities under each of the objectives • Implication???
Questions
Preliminary Costing Results
Cost by Strategic objectives Strategic objective 2019/20 2020/21 2021/22 2022/23 2023/24 Total SO.1: To create an enabling policy and legal environment necessary for improvement of nutrition outcomes across all sectors at national and sub national level. 0.08 0.76 0.26 0.41 0.32 1.83 SO. 2: To create, strengthen and sustain sectoral and Multi-Sectoral Nutrition coordination mechanisms at national and sub-national levels 0.63 0.57 0.59 0.63 0.25 2.67 SO. 3: To improve and strengthen human resource capacity for providing appropriate support to maternal and child nutrition at national and sub-national levels. 0.08 1.10 0.74 0.52 0.19 2.64 SO. 4: To develop and integrate a full package of nutrition-specific interventions into basic health care services at national and sub-national levels. 0.68 3.32 2.62 2.65 1.50 10.77 SO. 5: To improve policy and practices that enhance maternal and child nutritional status through optimal use of nutrition-sensitive services. 28.97 73.02 60.43 30.65 24.67 217.75 SO. 6: To address gender and social-cultural factors that hinder improvement of maternal, infant, and young child nutrition at national and sub national level. 3.10 3.52 3.54 3.20 3.10 16.46 SO. 7 : To strengthen organisational, institutional and policy framework for linking humanitarian relief, to recovery and development towards to nutrition improvement at national and sub national level. 9.01 11.30 11.29 8.99 9.10 49.70 Total per year 42.55 93.59 79.48 47.05 39.13 301.80
Weight of the cost by SO. 17% Strategic objective 7 5% Strategic objective 6 73% Strategic objective 5 4% Strategic objective 4 1% Strategic objective 3 1% Strategic objective 2 0% Strategic objective 1 0% 10% 20% 30% 40% 50% 60% 70% 80%
Cost by year of implementation 2023/24, 13% 2019/20, 14% 2022/23, 16% 2020/21, 31% 2021/22, 26%
Challenges • Resource tracking and Mobilization among partners, donors and other multi-sectoral actors • Alignment and identification of proposed activities under each of the objectives. • Lack of whole scope of identified nutrition interventions/activities under humanitarian and development response. • Implication???
Questions
THANK YOU
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