THE UNITED REPUBLIC OF TANZANIA · 2018-07-09 · THE UNITED REPUBLIC OF TANZANIA FOR COMPREHENSIVE...

PRESIDENT’S OFFICE REGIONAL ADMINISTRATION AND LOCAL GOVERNMENT

THE UNITED REPUBLIC OF TANZANIA

FOR COMPREHENSIVE SUPPORTIVE SUPERVISION IN IMPLEMENTATION OF THE

NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’s

TOOL KIT

MARCH 2018

NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’s i

FOR COMPREHENSIVE SUPPORTIVE SUPERVISION IN IMPLEMENTATION OF THE


TOOL KIT

MARCH 2018


NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’sii iii

LIST OF ABBREVIATIONS .............................................................................................................................................iv

FOREWORD ........................................................................................................................................................................v

SECTION 1:

GENERAL INTRODUCTION .......................................................................................................................................... 1

1.1 Malnutrition status

1.2 Why the tool kit? .............................................................................................................................................. 2

1.3 The use of tool kit in supportive supervision ............................................................................................ 2

1.4 Advantages of supportive supervision as opposed to traditional supervision? ................................ 2

1.5 The importance of supportive supervision ................................................................................................ 3

1.6 Objectives of supportive supervision in the implementation of the NMNAP ..................................... 4

1.7 How to use these tool kit ............................................................................................................................... 4

1.8 The process for developing the tool kit ...................................................................................................... 4

SECTION 2:SCOPE AND ROLES OF MINISTRY RESPONSIBLE FOR REGIONAL ADMINISTRATION ANDLOCAL GOVERNMENT, REGIONAL SECRETARIATS (RS) AND LOCAL GOVERNMENTAUTHORITIES (LGA) IN SUPPORTIVE SUPERVISION FOR NUTRITION ................................................................. 5

2.1 Introduction ..................................................................................................................................................... 5

2.2 The role of PO-RALG in supervising Regional Secretariats ..................................................................... 5

2.2.1 Areas to be covered by PO-RALG during supervision to Regional Secretariats .......................................5

2.3 The role of Regional Secretariats in supervising LGAs ............................................................................. 6

2.3.1 Areas to be covered in supervising LGAs .........................................................................................................6

2.4 The role of Local Government Authorities (LGAs) ..................................................................................... 6

2.4.1 Areas to be covered during supervision at Ward and Village Levels .........................................................6

SECTION 3:CHECKLISTS FOR SUPPORTIVE SUPERVISION AT DIFFERENT LEVELS ........................................................ 7

3.1 Purpose of checklists ..................................................................................................................................... 7

3.2 The six checklists and information contained .......................................................................................... 7

SECTION 4:

4.1 Introduction ..................................................................................................................................................... 8

4.2 Setting up a supportive supervision system ............................................................................................. 8

4.3 Formation of supervision teams .................................................................................................................. 8

4.4 Planning supportive supervisory visits ....................................................................................................... 9

4.5 Code of conduct for supervisors of supportive supervision visits ........................................................ 9

4.6 Conducting the Supportive Supervision visit ............................................................................................ 9

4.7 Performance Ranking and interpretation ................................................................................................ 10

4.8 Providing immediate Feedback ................................................................................................................. 10

4.9 Reporting ........................................................................................................................................................ 10

4.9.1 Scoring areas of assessment for each checklist .........................................................................................10

APPENDIXES

Appendix 1: National Nutrition Monitoring and Supervision Checklist for supervising Regions ............. 11

Appendix 2: Nutrition Monitoring and Supervision Checklist for Councils ................................................... 14

Appendix 3: Nutrition Monitoring and Supervision Checklist for facility ....................................................... 22

Appendix 4: Nutrition Monitoring and Supervision Checklist for Community ............................................. 34

Appendix 5: Nutrition Monitoring and Supervision Checklist for Private sector .......................................... 39

Appendix 6: Supervision Checklist: For NGOs, CBOs and FBOs at National, Regional, Council and ........... Community levels ............................................................................................................................... 41

Appendix 7: List of participants who developed the supportive supervision tool kit ................................. 42

TABLE OF CONTENTS

TABLE OF CONTENTS


NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’siv v

AAS Assistant Administrative Secretary

CDO Community Development Officer

CMSCN District/Council Steering Committee on Nutrition

CMT Council Management Team

CSOs Civil Society Organizations

CUAMM Italian NGO - Doctors with Africa

DACC District AIDS Control Coordinator

DAICO District Agriculture, Irrigation and Cooperative Officer

DCC District Consultative Committee

DED District Executive Director

DEO District Education Officer

DHO District Health Officer

DLFO District Livestock and Fisheries Officer

DMO District Medical Officer

DNuO District Nutrition Officer

DQA Data Quality Assessment

DRCHCo District Reproductive and Child Health Coordinator

ECD Early Childhood Development

FBOs Faith Based Organizations

HLSCN High-Level Steering Committee on Nutrition

IGN Iodine Global Network

IFA Iron Folic Acid

IMAM Integrated Management of Acute Malnutrition

LGAs Local Government Authorities

MIYCAN Maternal Infant Young Child and Adolescent Nutrition

MKUKUTA Mkakati wa Kupambana na Kupunguza Umaskini Tanzania

MoALF Ministry of Agriculture Livestock and Fisheries

MOFP Ministry of Finance and Planning

MOHCDGEC Ministry of Health, Community Development, Gender, Elderly and Children

MTEF Medium Term Expenditure Framework

NCD Non-Communicable Diseases

NGOs Non-Governmental Organizations

NI Nutrition International

NMNAP National Multisectoral Nutrition Action Plan

NSC Nutrition Steering Committee

PANITA Partnership in Nutrition in Tanzania

PMO Prime Minister’s Office

PO-RALG President’s Office – Regional Administration and Local Government

RACC Regional AIDS Control Coordinator

RAS Regional Administrative Secretary

RCC Regional Consultative Committee

RCHWCo Regional Community Health Workers Coordinator

REO Regional Education Officer

RHO Regional Health Officer

RIVO Regional Immunization and Vaccination Officer (RIVO)

RMO Regional Medical Officer

RMSCN Regional Multisectoral Steering Committee on Nutrition

RNuO Regional Nutrition Officer

RRCHCo Regional Reproductive and Child Health Coordinator

RS Regional Secretariat

RSWO Regional Social Welfare Officer

SBCC Social Behaviour Change Communication

TASAF Tanzania Social Action Fund

TDHS Tanzania Demographic and Health Survey

UNICEF United Nations Children’s Fund

USAID United States Agency for International Development

VASD Vitamin A Supplementation and Deworming

VC Village Council

VIDO Vaccine and Immunization District Officer

WDC Ward Development Committee

WFP World Food Programme

LIST OF ABBREVIATIONS

FOREWORD

Investing in nutrition contributes to national economic prosperity in various ways, including increases productivity, economic growth and facilitates poverty reduction through improved

physical work capacity, cognitive development, school performance, economic activity and health by reducing sickness and deaths.

Addressing malnutrition increases GDP

growth and reduces national budgetary costs

for custodial care and malnutrition-related

lost lives. Investing in nutrition is one of the

“best buys” for economic development as it

helps businesses and assists in social mobility,

through a more productive workforce and a

more affluent consumer base.

Thus, addressing malnutrition is a political choice to foster security, peace and stability. Nationally, it will greatly contribute to Tanzania’s political agenda of peace and stability and propelling the country into income country (MIC) status by 2025. Globally,

The development of these tool kit marks a key point in the way that supervision for nutrition is done. Instead of using the traditional vertical hierarchical approach to monitor performance, supportive supervision provides a mechanism for an interactive approach between supervisors and supervisees, that guides and coaches workers to promote compliance with standards of practice to assure delivery of quality services. In this process, the supervisors and supervisees work together as a team to meet common goals and objectives as articulated by the National Multisectoral Nutrition Action Plan (NMNAP) 2016/17 – 2020/21 that was approved by the High-Level Steering Committee on Nutrition in October 2016 and launched by the Prime Minister, Hon. Majaliwa Kassim Majaliwa in Dodoma on 6th September 2017.

These tool kit will guide PO-RALG, Regional Secretariats (RS) and Local Government Authority (LGA) supervisory teams in providing oversight and ensuring accountability in implementation of the NMNAP. Critically it will also help develop the implementation capacity of nutrition frontliners at various levels to support Regional Commissioners in implementing the “Nutrition Compacts” that they signed with the Minister of State PO-RALG on behalf of Vice-President. The checklists in the appendixes provide quick reference to the supervision teams and should be adapted to the local contexts.

NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’svi

I call upon all internal and external stakeholders to start using this tool kit in doing our supportive supervision for nutrition. I would also like to request the various stakeholders to continue to support us in the implementation and refining of the tool kit as experience and insights are gained.

Dr. Zainab A.S. Chaula,Acting Permanent Secretary,President’s Office-Regional Administration and Local Government

I would like to thank all those who participated in the extensive consultation that developed this tool kit: Mr. Stephen J. Motambi - Assistant Director Nutrition Services – PO-RALG, Mariam Nakuwa – Nutrition Officer PORALG and Mwita J. M. Waibe - Nutritionist and Health Policy Analyst of PO-RALG, led the process with huge support from Nutrition Officers at Regional and District/Town/City Council levels; UNICEF provided financial and technical support and Dr. Festo Kavishe, who was the NMNAP Lead Facilitator and writer, moderated and synthesized various inputs into this document. Others are PMO, nutrition sensitive MDAs (MOHCDGEC, MOFP, MoALF, TFNC), Ministry of Health Zanzibar (Nutrition Unit), UN Agencies (UNICEF and WFP), Development Partners (USAID), The World Bank and several nutrition focused NGOs (NI, CUAMM, IMA World Health, Save the Children, Mwanzo Bora, PANITA, ENRICH, IGN).

1.1 Malnutrition status;

Taking a long-term perspective, the undernutrition situation could best be described as (i) very high and constant over time and in all Regions of the country during the 1960s, 1970s and early 1980s; (ii) responding to specific interventions during the mid-1980s and 1990s; (iii) progressing too slowly despite good economic progress in the early 2000s; and (iv) improving but still unacceptably high with a double burden of undernutrition and over nutrition during the 2010s.

The levels of stunting in children 0-59 months reduced from a prevalence of 50 percent in the 1990s to 34 percent in the 2015/16 TDHS, but still above the average of 30 percent for Africa and falls within the category of “high” in public health significance. Due to the rate of population growth outstripping the rate of reduction, the absolute numbers of stunted children increased from below 2.0 million in the early 2000’s to about 3.0 million in 2010.

However, a decline was observed in 2015 with 2.7 million stunted children. During the same period, the prevalence of underweight declined from 25 percent to 14 percent close to meeting the MDG1 target of halving underweight by 2015.

GENERAL INTRODUCTION

01

A review of the nutrition

status trends based

on anthropometric

measurements confirms

that there have been

some significant declines

in the prevalence of

undernutrition during the

last two decades.

The levels of stunting in children 0-59

months reduced from a prevalence of 50

percent in the 1990s to

children under five years of age estimated

to be acutely malnourished in 2015 of whom 100,00 were categorized as severe.

wasting in children 0-59 months, declined

from 8 percent in 1992 to 4.5 percent in

2015/16

34%

600,000

8%

NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’s 1


NATIONAL MULTISECTORAL NUTRITION RESPONSE IN REGIONS AND LGA’s2 3

In the same vein, wasting in children 0-59 months, declined from 8 percent in 1992 to 4.5 percent in 2015/16 reaching the WHA 2025 target of below 5 percent (see figure 3). However, due to the huge population and rapid population increase, the absolute numbers of those acutely malnourished are high and also increasing, with some 600,000 children under five years of age estimated to be acutely malnourished in 2015 of whom 100,00 were categorized as severe. The risk of death is much higher amongst children with severe acute undernutrition, and as such require concomitant efforts as part of a comprehensive program which focuses on the alleviation of chronic undernutrition.

1.2 Why the tool kit?

1. These tool kit were developed to assist in providing supportive supervision to nutrition stakeholders in implementation of the national multisectoral nutrition response at the Regional and Local Government Authority (LGA) levels. The roles and responsibilities for each stakeholder are defined by the separate terms of reference (TOR) of the Regional and Council Multisectoral Steering Committees on Nutrition (R&CMSCN) developed concurrently with these tool kit.

2. The tool kit identifies the roles of National level, Regional Secretariats (RS) and LGAs in supervising the implementation of the national multisectoral nutrition response, which for the period 2016/17 – 2020/21 is embodied by the National Multisetoral Nutrition Action Plan (NMNAP) that was approved by the High-Level Steering Committee on Nutrition (HLSCN) in October 2016. The tool kit also offers six checklists on nutrition monitor ing and supportive supervisions at the various levels: Regional, Council, facility, community, CSOs and the private sector.

1.3 The use of tool kit in supportive supervision

3. The tool kit will facilitate Supportive supervision process happen, aiming at guiding, monitoring, and coaching workers to promote compliance with standards of practice and assure the delivery of quality services. The supervisory process permits supervisors and supervisees the opportunity to work as a team to meet common goals and objectives, which in this respect are articulated in the National Multisectoral Nutrition Action Plan (NMNAP) of 2016-2021.

1.4 Advantages of supportive supervision as opposed to traditional supervision?

4. In the past, supervision for nutrition from the central level was conducted by programme leaders and partners in a vertical hierarchical manner, based on the interventions being implemented. There was no critical engagement of the lower level experts in conducting such exercises. This approach caused variations between partners and local experts from respective locations. Furthermore, adopting supportive supervision was challenged by limited implementation capacity at all levels

5. Moreover, top down challenged by inefficient personnel to offer supervisors often lack the technical, managerial and supervisory skills needed to effectively evaluate nutrition interventions across sectors for which they may not be responsible. In addition to assessing performance, supervisors are also expected to mentor, monitor interventions, evaluate management and ensure that the interventions are implemented properly.

Mentorship is a system of practical training and consultation, that fosters the ongoing professional development to yield sustainable high-quality nutrition outcomes.

6. Moving from traditional, hierarchical supervision systems to more supportive

Table 1: Comparison of traditional and supportive supervision (Adopted from Marquez and Kean, 2002)

Action Supportive supervision Traditional supervision

Who performs supervision?

External supervisors designated by the service delivery organization (PO-RALG in our case); staff from other stakeholders; colleagues from the same team (internal supervision); Regional and Council Multisectoral Steering Committees on Nutrition; Ward, Village/Mtaa community health committees; and staff themselves through self-assessment

External supervisors designated by the service delivery organization

When does supervision happen?

Continuously: during routine work; team meetings, committee meetings; and visits by external supervisors

During periodic visits by external supervisors

What happens during supervision encounters?

Observation of performance and comparison to standards; provision of corrective and supportive feedback on performance; discussion with clients; provision of technical updates or tool kit; onsite training; use of data and client input to identify opportunities for improvement; joint problem- solving; follow-up on previously identified actions

Inspection of facility; review of records and supplies; supervisor makes most of the decisions; reactive problem-solving by supervisor; little feedback or discussion of supervisor observations

What happens after supervision encounters?

Actions and decisions recorded; ongoing monitoring of weak areas and improvements; follow-up on prior visits and problems

No or irregular follow-up

ones requires innovative thinking, buy-in by stakeholders and time to change attitudes, perceptions, mindsets and practices. Due to its usefulness in improving performance in a more sustainable way, various partners now recognize the importance of supportive supervision in implementing their programs.

1.5 The importance of supportive supervision.

7. The process of supportive supervision promotes quality, strengthens relationships within the system, focusing on the identification and resolution of problems, helps to optimize the allocation of resources and promotes high standards, teamwork and improved two-way communication. When

done well, supportive supervision accelerates the achievement of goals and objectives.

8. Supportive supervision also ensures uniformity to set standards, identifying problems and solving them in a timely manner and making follow-up on decisions reached during previous supervision visits. It should be noted that, supportive supervision should promote an encouraging, joint problem solving atmosphere in which to identify and



address skills, attitudes and practices needing improvement. When strengths are found announce them in public; but when problems are found, discuss them in private directly with the person or team concerned.

1.6 Objectives of supportive supervision in the implementation of the NMNAP

9. The main objective of supportive supervision in the implementation of the NMNAP is to support the performance of nutrition implementers through enhancing their skills, knowledge and abilities with the aim of improving the impact of nutrition interventions at Regional and Local Government Authorities.

1.7 How to use these tool kit

10. In using these tool kit, supervisors and supervisees should adapt it to their local context and their specific sectors, ensuring basic standards are met. While the Tool kit are mainly meant to be used by supervisors of nutrition programs, they are crafted in such a way that the checklists can also be used by anyone interested in understanding the performance of nutrition interventions from the Regional to the community level. It is important that users of the tool kit share their results and experiences with others so that improvements can be made.

1.8 The process for developing the tool kit

11. This tool kit was developed through an extensive multi-stakeholder consultative process organized by PO-RALG and funded by UNICEF. PO-RALG led the process with huge support from Nutrition Officers at Regional and District/Town/City Council levels. Other key participants were PMO, nutrition sensitive MDAs (MOHCDGEC, MOFP, MoALF, TFNC), Ministry of Health Zanzibar (Nutrition Unit), UN Agencies (UNICEF and WFP), Development Partners (USAID), The World Bank and several nutrition focused NGOs (NI, CUAMM, IMA World Health, Save the Children, Mwanzo Bora, PANITA, ENRICH, IGN).

The initial draft was developed in a workshop held in Morogoro (August 21-25, 2017), followed by a task team review workshop held in Dodoma October 30th – November 3rd 2017, which developed the second draft. The second draft was validated by a workshop held also in Dodoma November 13-15th, 2017. The Dodoma workshops and writing of this document were facilitated by Dr. Festo Kavishe, who was the Lead Facilitator and writer of the National Multisectoral Nutrition Action Plan (NMNAP). The full list of participants in the development of these tool kit is shown in appendix 7.

SCOPE AND ROLES OF MINISTRY RESPONSIBLE FOR REGIONAL ADMINISTRATION AND LOCAL GOVERNMENT, REGIONAL SECRETARIATS (RS) AND LOCAL GOVERNMENT AUTHORITIES (LGA) IN SUPPORTIVE SUPERVISION FOR NUTRITION

02

2.1 Introduction

12. Cascading supportive supervision from the national to the community level and ensuring participation of various key nutrition stakeholders at the appropriate level is key to its successful implementation and sustainability. Supportive supervision should also follow the overarching strategy of the NMNAP, which is “Multisectoral Community-Centered approach”. Thus, supportive supervision should ensure the development of capacity (of implementers and systems) at all levels to support the community level to address the malnutrition challenge. After all, it is at the community level that malnutrition develops and it is at that level that the impact of interventions will be felt most.

2.2 The role of PO-RALG in supervising Regional Secretariats

13. President’s Office, Regional Administration

and Local Government (PO-RALG) is the key implementing arm of government within the framework of the ‘Decentralization by Devolution’ policy of the Government of Tanzania. As far as nutrition is concerned, PO-RALG has the mandate to coordinate, supervise and provide technical support to Regions and Local Government Authorities. Therefore, PO-RALG must ensure the provision of adequate support to LGAs and Regional Secretariats by strengthening their capacities to undertake planning, implementation and monitoring of nutrition activities in accordance with the decentralization by devolution policy.

2.2.1 Areas to be covered by PO-RALG during supervision to Regional Secretariats

14. The supportive supervision at Regional level will be conducted by the National/PO-RALG team. The team provides supportive supervision to the Regional Secretariat (RS) every quarter. The team will conduct the supportive supervision on RS’s nutrition interventions. Using a checklist (see Appendix



1-6), the team shall cover the following assessment areas: -

üHuman ResourceüPlanning and budgetingüFinance and expenditureüMultisectoral coordinationüLogistic and suppliesüTechnical issues – though not in the check

list it is important to get a feeling of the technical capacity of technical persons at their workplace.

2.3 The role of Regional Secretariats in supervising LGAs

15. The mandate of Regional secretariats is to supervise and provide technical support to Local Government Authorities (LGAs). In this regard, they are responsible for ensuring that adequate support is provided to LGAs for strengthening their capacities to undertake planning, implementation and monitoring of nutrition activities in line with the Decentralization by Devolution (D by D) policy.

2.3.1 Areas to be covered in supervising LGAs

16. The supervision at LGA’s level initiated by PO-RALG shall be conducted by a team of experts from PO-RALG combined with officials appointed by the Regional Administrative Secretary(RAS), which should include nutritionists and others. While initiated by RS shall be composed of a team of Regional Secretariat (RS) officials.

17. The team provides supportive supervision at LGAs quarterly and using a checklist (see Appendix 2), shall cover the following areas:üHuman ResourceüPlanning and BudgetingüFinance and ExpenditureüLogistic and suppliesüTechnical issues (Nutrition specific and

sensitive interventions) based on the sevenkey result areas of the NMNAP 1

2.4 The role of Local Government Authorities (LGAs)

18. Local government Authorities remain the main implementers in delivering public services. In this regard, their responsibilities include implementing nutrition activities in accordance with the National Multisectoral Nutrition Action Plan (NMNAP) and policies and procedures of the government of Tanzania. They also ensure appropriate and fair amount of resources are available for nutrition activities at the district, ward and village level. Finally, LGAs play a vital

role in monitoring progress and in coordination with other stakeholders implementing nutrition interventions in their respective Councils.

2.4.1 Areas to be covered during supervision at Ward and Village Levels

19. The supervision at Ward and Village levels as initiated by RS shall be conducted by a team composing members from RS and LGA’s. The exercise should be conducted on quarterly basis.

20. The areas of focus during supportive supervision at Ward and Village level include:

üInvolvement of the committees in planning and budgeting

üOrientation and follow up of WDCs and VC on nutrition

üInclusion of nutrition agenda in WDCs and VC meetings

üFunctionality of nutrition agenda from WDCs and VC

üCommunication between WDC/VC and higher level committees

1 The seven NMNAP key result areas (KRAs) are (1) Maternal, Infant, Young Child and Adolescent Nutrition (MIYCAN), (2) Micronutrients (3) Integrated Management of Acute Malnutrition (IMAM) (4) Diet Related Non-Communicable Diseases (DRNCD) (5) Multisectoral Nutrition Sensitive Interventions (6) Multisectoral Nutrition Governance and (7) Multisectoral Nutrition Information System.

CHECKLISTS FOR SUPPORTIVE SUPERVISION AT DIFFERENT LEVELS

03

3.1 Purpose of checklists

21. The purpose of the supportive supervision checklist is to serve as a guiding tool for use by PO-RALG, RS and LGA supervisory teams in overseeing nutrition implementation at the Regional Secretariat (RS), Local Government Authorities (LGAs), Ward and Village. The checklists are designed for quick reference that can be read individually or used for orientation of supportive supervision teams. In this regard, the checklist provides its users with important information to improve the quality of supervision in a structured and systematic way.

22. The checklists are important because they can be used to: -üEnsure standardization and harmonization

in conducting supportive supervision of nutrition interventions at the different levels.

üGuide the supervisory team during the supervision process.

üProvide guidance on planning and implementation of comprehensive nutrition supportive supervision at RS and LGAs levels.

3.2 The six checklists and information contained

23. Six checklists have been developed for use. These are: -

üAppendix 1: Nutrition Monitoring and Supervision Checklist at Regions

üAppendix 2: Nutrition Monitoring and Supervision Checklist at Councils

üAppendix 3: Nutrition Monitoring and Supervision Checklist at facility level

üAppendix 4: Nutrition Monitoring and Supervision Checklist at Community

üAppendix 5: Nutrition Monitoring and Supervision Checklist at Private sector

üAppendix 6: Supervision Checklist for NGOs, CBOs and FBOs at Council and Community levels.

24. Key assessment areas covered in each checklist include: üNutrition Governance (human resources)

üPlanning and budgeting (including sources of funds, expenditures),

üMultisectoral Nutrition Coordination

üLogistics and supply, and

üTechnical issues based on Key Result Areas (only for Regions, Councils and community levels)



PROCEDURES AND TASKS FOR SUPPORTIVE SUPERVISION

04

4.1 Introduction

25. This section describes supportive supervision procedures to be undertaken before, during and after supervision that include setting up the system, planning, getting started, conducting supportive supervision, immediate feedback, wind up, report writing and follow up activities.

26. The process of supportive supervision could be summarized in four main steps: -

üStep 1: Set up a supportive supervision system. An understanding of the context is important to be able to mobilize appropriate support. Make supervisors part of the training process.

üStep 2: Plan regular supervision visits: Work with supervisors to plan and conduct supportive supervision.

üStep 3: Conduct supervisory visits. Prepare in advance for supervisory visits. Set expectations for performance, monitor and assess performance to identify gaps and solve problems in positive ways.

üStep 4: Follow up activities identified by the visits, stay motivated and build sustainability of the system.

4.2 Setting up a supportive supervision system

27. A critical first step in setting up a supportive supervision system is an agreement on its need and change of mindset and attitudes of both supervisors and supervisees who have been accustomed to the traditional hierarchical inspectorial type of supervision. Determined to make this change, PO-RALG has decided to institute this system in the supervision of the implementation of the NMNAP. To be able to supervise in the different geographical and cultural contexts, supervisory teams need to understand the multisectoral community centred strategic approach of the NMNAP and the Decentralization and Devolution approach of PO-RALG.

4.3 Formation of supervision teams

28. The organizer of supportive supervision shall appoint a team of not less than three people of different educational backgrounds and professions. The team shall have a team leader and be composed of experts with a mixture of competencies and skills according to area of supervision. The team leader shall play

the role of a catalyst and facilitator between the supervisory team and the office to be supervised. He/she should make sure that good communication has been done prior to the departure of the supervisory team to the head office of the site where supervision is to be conducted. He/she should inform the management the purpose of the supervision, the composition of the supervisory team, areas or scope of the supervision as well as the duration of the supervision exercise. The team leader should make sure that the rehearsal of supervision tools has been done before the exercise so that the team should get deep understanding as to why the supervision is being conducted.

4.4 Planning supportive supervisory visits

29. This is the stage where activities to be performed during the supportive supervision are identified and scheduled from initial to last stage of the activity. From this stage, the supervision initiator should establish the goals of the supervision, allocate the budget, prepare necessary documents and staff, and communicate with officials of the intended location about the scheduled supervision.

30. Essential documents that should be made available for the perusal of supportive supervision team members prior, during and after supervision include: -üLetter of (notification) bearing number and

names of officials

üSupervisor code of conducts

üSupervision checklists

üReports from previous supportive supervision

31. Timing and duration of visits: Deciding on the timing and duration of the supportive supervision exercise should be part of the planning process and be agreed in advance

between the supervisory team and those being supervised, at least two weeks before the supervision is conducted. This will allow for both parties to be available and prepare effectively f or a successful mission.

4.5 Code of conduct for supervisors of supportive supervision visits

32. During the planning stage, the supervisory team should discuss how they should behave when conducting supportive supervisory visits. Team members, individually and collectively should demonstrate and abide by the following ethical values: -üRespect

üPresentation including dressing codes

üCommunication (interaction)

üMode of providing technical support (Avoid promise beyond your control)

üEmotion control

üPunctuality

üAccountability

4.6 Conducting the Supportive Supervision visit

33. At this stage, the supervisory team travels to the supervision site where the team leader shall introduce the team to the RAS/DED/WEO/VEO etc., and explain the purpose and the duration of the supportive supervision mission.

34. After consultation with RAS or DED, the team should start conducting the supervision. At this stage, the team leader shall ask to meet with key staff for interaction from whom the needed information should be obtained including different documents to enable the supervision activity. As far as the concept of supportive supervision is concerned, the activity should be accompanied by provision of technical



support, coaching and mentoring to the supervisees where necessary. The supporting supervisor should behave like a colleague.

35. In carrying out the supportive supervision, the following methods are to be used: -� Briefing meetings with relevant Officials

and do face to face interviews with them and community members where necessary.

� Observation through Field work and visits.

� Review and verification of relevant documents

� Focused group discussions

� Coaching

� Exit (debriefing) meeting with VEO/WEO/DED/RAS

4.7 Performance Ranking and interpretation

36. Adherence and compliance to standards and performance is translated into a score of five arranged chronologically from excellent to poor performance. The interpretation of the scale is elaborated in Table below.

Table 2: Performance Scale and interpretation Score Concept 5 4 3 2 1

Performance Excellent Very Good Good Fair Poor

Percentage 80 – 100 60 – 79 40 – 59 20 - 39 0 – 19

Frequency Always Often Sometimes Rarely Never

Agreement Strongly Agree Agree

Neither agree/ nor disagree

Disagree Strongly Disagree

4.8 Providing immediate Feedback

37. The supportive supervisory team should make sure immediate feedback is provided to RS or LGA officials during and after the activity. This means the team should work collaboratively with RS and LGA’s officers to make sure that

cooperation is strengthened and everything is going smoothly. In case of any obstacles, do not hesitate to contact the officer in charge for remedial of the situation.

38. After completing their work, the team must make sure the summary of the activity is made, highlighting key issues. The team leader shall provide brief feedback to RAS or DED/MED the head of their host office. The debrief should start by appreciating their supervisees on the areas they did well followed by comments on areas needing improvements and recommend way forwards identifying responsible persons and timelines. The team leader should be cooperative, diplomatic and humorous while debriefing.

39. The comprehensive supervision feedback should be given back to supervisees in the period of not more than 14 days after completion of activity.

4.9 Reporting

40. Both hard and soft copies of the supportive supervision report should be submitted 14 days after the completion of the activity. The data obtained from the supervision should be discussed by all team members for agreement on issues discovered during the activity and systematically analyzed, interpreted and finally written. The report should be concise and well organized, presenting the assessment in an objective and clear manner.

4.9.1 Scoring areas of assessment for each checklistArea of assessment in checklist

Maximum score Comments

Human Resources 5

Planning and Budgeting 5

Multisectoral coordination 5

Logistics and supplies 5

Total score 20

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k th

e: -

1. H

UMAN

RES

OUR

CES

(Tot

al sc

ore

30)

Num

ber o

f Nut

ritio

n O

ffice

rs (p

rofe

ssio

nals

) em

ploy

ed a

t the

Reg

iona

l le

vel (

Assi

gn 1

0 po

ints

if th

ere

are

3 or

mor

e nu

triti

on o

ffice

rs, 5

poi

nts

if le

ss th

an 3

and

0 if

non

e)10

Regi

onal

hum

an re

sour

ce d

atab

ase

(Sen

iorit

y lis

t),

Is th

ere

an a

ppoi

nted

Reg

iona

l Nut

ritio

n O

ffice

r?

5Pr

esen

ce o

f a le

tter

of a

ppoi

ntm

ent a

s a se

ctio

n le

ader

.

Does

th

e ap

poin

ted

Regi

onal

N

utrit

ion

Offi

cer

have

a

lett

er

of

appo

intm

ent a

nd jo

b de

scrip

tion?

Che

ck in

the

pers

onal

file

.5

Lett

er o

f app

oint

men

t, si

gned

job

desc

riptio

n,

Avai

labi

lity

of

adeq

uate

an

d re

liabl

e w

orki

ng

offic

e sp

ace

and

equi

pmen

t 5

Avai

labi

lity

of w

orki

ng o

ffice

spac

e fo

r nut

ritio

nist

s,

tabl

es, c

hairs

and

wor

king

tool

s.

Is th

ere

any

evid

ence

of a

tten

ding

on

job

train

ings

/wor

ksho

ps re

late

d to

nut

ritio

n?

5Av

aila

bilit

y of

trai

ning

doc

umen

t, w

orks

hop

feed

back

fil

es, c

ertif

icat

e of

att

enda

nce

2. P

LANN

ING

AND

BUDG

ETIN

G

(Tot

al o

f 50

poin

ts)

Is th

ere

a Re

gion

al N

utrit

ion

stra

tegi

c pl

an? (

10 p

oint

s for

yes

, 0 fo

r no)

10

Regi

onal

Nut

ritio

n st

rate

gic

plan

doc

umen

t

Are

Nut

ritio

n ac

tiviti

es in

corp

orat

ed in

the

Regi

onal

ann

ual p

lans

an

d bu

dget

as p

er to

o ki

t fro

m P

O-R

ALG?

(10

poin

ts if

fully

, 5 p

oint

if

part

ially

and

0 if

not

don

e)10

Regi

onal

ann

ual p

lans

and

bud

get (

MTE

F) th

at h

ave

inco

rpor

ated

the

Regi

onal

mul

tisec

tora

l act

iviti

es a

nd

budg

et.

Does

the

plan

ning

of n

utrit

ion

activ

ities

adh

ere

to a

mul

ti-se

ctor

al

appr

oach

?10

At le

ast o

ne a

ctiv

ity p

er n

utrit

ion

sens

itive

im

plem

entin

g se

ctor

in th

e Re

gion

al a

nnua

l pla

ns a

nd

budg

et (M

TEF/

).

Has

the

Reg

iona

l m

utlis

ecto

ral

nutr

ition

act

ion

plan

bee

n al

loca

ted

fund

ing

in t

he c

urre

nt f

inan

cial

yea

r as

bud

gete

d? (

10 p

oint

s if

as

budg

eted

, 7 p

oint

s if o

ver 5

0%; 5

poi

nts i

f <50

%; a

nd 0

if n

one)

10To

tal a

mou

nt o

f fun

d al

loca

ted

for N

utrit

ion

in th

e Re

gion

al a

nnua

l pla

ns a

nd b

udge

t (M

TEF/

SBAS

S)

base

d on

Reg

iona

l nut

ritio

n ac

tion

plan

.

Wha

t ar

e th

e so

urce

s of

the

nut

ritio

n bu

dget

in

the

Regi

on f

or t

he

curr

ent f

inan

cial

yea

r? (1

0 po

ints

if fr

om a

ll ex

pect

ed s

ourc

es, 3

poi

nts

from

Gov

ernm

ent,

2 po

ints

bas

ket f

und,

2 p

oint

s de

velo

pmen

t fun

d, 2

po

ints

OC,

1 p

oint

for o

ther

stak

ehol

ders

)

10To

tal a

mou

nt o

f fun

d al

loca

ted

for N

utrit

ion

in th

e Re

gion

al a

nnua

l pla

ns a

nd b

udge

t (M

TEF/

SBAS

S).



3. IM

PLEM

ENTA

TIO

N O

F AC

TIVI

TIES

AND

FIN

ANCI

AL

EXPE

NDIT

URE

(TOT

AL O

F 30

PO

INTS

)

Impl

emen

tatio

n of

the

plan

ned

Nut

ritio

n ac

tiviti

es in

the

repo

rtin

g pe

riod

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2

poin

ts if

20-

<50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d.5

Regi

onal

fina

ncia

l rep

ort

Expe

nditu

re V

s allo

cate

d fu

nds f

or th

e di

ffere

nt fu

ndin

g so

urce

s

Gove

rnm

ent f

unds

(5

poi

nts i

f ove

r 75%

; 4 p

oint

s if 6

0-<7

5%; 3

poi

nts i

f >50

-<60

%; 2

poi

nts i

f 20

-<50

%; 1

poi

nt if

1-<

20%

; and

0 p

oint

s if n

one

impl

emen

ted

5Re

gion

al fi

nanc

ial r

epor

t

Bask

et F

und

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2 p

oint

s if

20-<

50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Regi

onal

fina

ncia

l rep

ort

Deve

lopm

ent F

und

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2 p

oint

s if

20-<

50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Regi

onal

fina

ncia

l rep

ort

OC

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2 p

oint

s if

20-<

50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Regi

onal

fina

ncia

l rep

ort

Oth

er S

take

hold

ers

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2 p

oint

s if

20-<

50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Regi

onal

fina

ncia

l rep

ort.

4. M

ULTI

SECT

ORA

L NU

TRIT

ION

COO

RDIN

ATIO

N (T

OTAL

OF

50 P

OIN

TS)

Pres

ence

of a

nnua

l nut

ritio

n w

ork

plan

alig

ned

with

NM

NAP

10

Regi

onal

ann

ual w

ork

plan

Func

tiona

l M

ulti-

Sect

oral

Nut

ritio

n St

eerin

g Co

mm

ittee

(M

SCN

): (1

0 po

ints

if fu

lly fu

nctio

nal;

5 po

ints

if p

artia

lly fu

nctio

nal;

0 po

ints

if n

on-

func

tiona

l)10

Avai

labi

lity

of si

gned

mee

ting

min

utes

Is th

e co

mpo

sitio

n of

MSC

N c

onsi

sten

t with

the

TOR

of th

e RM

SCN

(10

poin

ts if

fully

con

sist

ent,

7 po

ints

if m

ostly

con

sist

ent,

5 po

ints

if a

bout

50

% c

onsi

sten

t, 1

poin

t if i

t exi

sts b

ut n

ot c

onsi

sten

t with

TO

R)10

TOR,

cop

y of

app

oint

men

t let

ters

in M

SCN

file

,

Does

MSC

N a

ppea

r in

the

Regi

on’s

mee

ting

cale

ndar

?5

Regi

onal

’s m

eetin

g ca

lend

ar

Are

stak

ehol

ders

’ im

plem

enta

tion

repo

rts

subm

itted

in

the

MSC

N

mee

tings

?5

Repo

rt in

thei

r file

s and

then

cro

ss-c

heck

with

the

Regi

onal

ann

ual p

lans

and

bud

get (

MTE

F/SB

ASS)

.

Are

stak

ehol

ders

’ car

ryin

g ou

t act

ions

as a

gree

d?5

Chec

k th

e m

inut

es o

f MSC

N a

nd im

plem

entin

g re

port

Are

perio

dic

supp

ortiv

e su

perv

isio

n co

nduc

ted?

5Pe

riodi

c su

ppor

tive

supe

rvis

ion

repo

rt.

5. L

OGI

STIC

S AN

D SU

PPLY

(T

otal

of 1

0 po

ints

)

Are

the

nutr

ition

equ

ipm

ent a

nd su

pplie

s dis

trib

utio

n pl

an a

nd

logi

stic

al a

rrang

emen

ts in

pla

ce? (

10 p

oint

s if a

ll in

pla

ce; 5

poi

nts i

f pa

rtia

lly in

pla

ce; 0

if n

one

in p

lace

)10

Requ

isiti

on /o

rder

ing

arra

ngem

ents

, Dis

trib

utio

n sc

hedu

les,

del

iver

y ar

rang

emen

ts

6.

MO

NIT

ORI

NG

AND

EVAL

UATI

ON

(Tot

al 4

0 po

ints

) Is

ther

e a

Nut

ritio

n In

form

atio

n Sy

stem

in p

lace

?

10Ve

rify

phys

ical

ly:

5Re

port

s are

pre

pare

d an

d se

nt o

ut to

the

appr

opria

te

leve

l (co

pies

of r

epor

ts w

ith c

over

ing

lett

ers)

2

5La

test

CH

NM

repo

rt

1

5La

test

BN

A re

port

2

5La

test

JM

NR

repo

rt

1

5N

utrit

ion

scor

ecar

d re

port

3

5N

utrit

ion

repo

rt g

ener

ated

from

HM

IS re

gist

ers

3



Ap

pen

dix

2:

Nut

riti

on M

onit

orin

g an

d Su

perv

isio

n Ch

eckl

ist f

or C

ounc

ils

Regi

on:

……

……

……

……

……

……

…...

.……

……

......

......

...…

......

......

......

.....

Coun

cil N

ame:

……

……

……

……

……

……

……

……

……

……

…...

......

......

......

...

Date

of s

uper

visi

on:

……

……

……

……

……

……

……

……

……

……

……

……

……

Area

s of a

sses

smen

tDe

scrip

tion

Scor

e gu

ide

Mea

ns o

f ver

ifica

tion

Resp

onse

Scor

eRe

mar

k/Ac

tion

Nut

ritio

n go

vern

ance

1. H

UMAN

RES

OUR

CE F

OR

NUTR

ITIO

N (T

otal

of 3

0 po

ints

)

Num

ber o

f Nut

ritio

n O

ffice

rs (p

rofe

ssio

nals

) ava

ilabl

e in

a C

ounc

il (A

ssig

n 10

po

ints

if th

ere

are

3 or

mor

e nu

triti

on o

ffice

rs, 5

poi

nts i

f les

s tha

n 3

and

0 if

none

).10

Hum

an R

esou

rce

data

base

(sen

iorit

y lis

t)

Is th

ere

any

appo

inte

d Co

unci

l Nut

ritio

n O

ffice

r? (5

poi

nts f

or y

es, 0

poi

nts i

f no)

5Pr

esen

ce o

f a le

tter

of a

ppoi

ntm

ent a

s a se

ctio

n le

ader

.

Does

the

appo

inte

d Co

unci

l Nut

ritio

n O

ffice

r hav

e a

task

des

crip

tion

(Che

ck in

th

e pe

rson

al fi

le)?

5Pr

esen

ce o

f a si

gned

job

or ta

sk d

escr

iptio

n

Avai

labi

lity

of a

dequ

ate

and

relia

ble

wor

king

offi

ce sp

ace

and

equi

pmen

t for

N

utrit

ioni

sts

5O

ffice

spac

e, ta

bles

, cha

irs a

nd w

orki

ng to

ols (

com

pute

r, pr

inte

r).

Is th

ere

any

evid

ence

of a

tten

ding

on

job

train

ings

/wor

ksho

ps re

late

d to

nu

triti

on? (

Cons

ider

trai

ning

form

oth

er se

ctor

s)5

Avai

labi

lity

of d

ocum

ent t

augh

t, w

orks

hop

feed

back

file

s,

cert

ifica

te o

f att

enda

nce

2. P

LANN

ING

AND

BUD

GETI

NG (T

otal

of

60 p

oint

s)

Is th

ere

a Co

unci

l Nut

ritio

n st

rate

gic

plan

? (10

poi

nts f

or y

es, 0

for n

o)10

Avai

labi

lity

of C

ounc

il N

utrit

ion

Stra

tegi

c Pl

an

Are

nutr

ition

act

iviti

es in

corp

orat

ed in

to th

e Co

unci

l ann

ual p

lan

and

budg

et a

s pe

r too

l kit

from

PO

-RAL

G? (1

0 po

ints

if fu

lly, 5

poi

nts i

f par

tially

and

0 if

not

)10

Cou

ncil

annu

al p

lans

and

bud

get (

MTE

F), C

CHP

Does

the

plan

ning

of n

utrit

ion

activ

ities

adh

ere

to a

mul

ti-se

ctor

al a

ppro

ach?

10At

leas

t one

act

ivity

per

nut

ritio

n se

nsiti

ve se

ctor

in th

e Co

unci

l an

nual

pla

ns a

nd b

udge

t (M

TEF)

Has

the

Coun

cil m

utlis

ecto

ral n

utrit

ion

actio

n pl

an b

een

allo

cate

d fu

ndin

g in

cu

rren

t fin

anci

al y

ear a

s bud

gete

d? (1

0 po

ints

if a

s bud

gete

d, 7

poi

nts i

f ove

r 50

%; 5

poi

nts i

f <50

%; a

nd 0

if n

one)

10Co

unci

l ann

ual p

lans

and

bud

get (

MTE

F/SB

ASS)

bas

ed o

n Co

unci

l nut

ritio

n ac

tion

plan

.

Wha

t are

the

sour

ces o

f the

Cou

ncil

nutr

ition

bud

get f

or th

e cu

rren

t fin

anci

al

year

? (10

poi

nts i

f fro

m a

ll ex

pect

ed so

urce

s, 3

poi

nts f

rom

Gov

ernm

ent,

2 po

ints

bas

ket f

und,

2 p

oint

s dev

elop

men

t fun

d, 2

poi

nts O

C, 1

poi

nt fo

r oth

er

stak

ehol

ders

)

10Co

unci

l ann

ual p

lans

and

bud

get (

MTE

F/SB

ASS)

.

Do y

ou h

ave

a lis

t of n

utrit

ion

part

ners

wor

king

in th

e ar

ea5

Abst

ract

list

of w

orki

ng p

artn

ers i

n th

e Co

unci

l (DC

DO)

How

man

y of

them

hav

e pl

ans i

ncor

pora

ted

into

ann

ual C

ounc

il bu

dget

?5

CCH

P/M

TEF

Tota

l am

ount

of f

und

allo

cate

d fo

r nut

ritio

n ac

tiviti

es in

the

curr

ent f

inan

cial

ye

ar.

Show

am

ount

Annu

al w

ork

plan

s, C

CHP/

MTE

EF

Tota

l am

ount

of f

und

allo

cate

d fo

r nut

ritio

n ac

tiviti

es in

the

curr

ent r

epor

ting

perio

dSh

ow

amou

ntAn

nual

wor

k pl

ans,

CCH

P/M

TEEF

Tota

l am

ount

of G

over

nmen

t fun

d al

loca

ted

for n

utrit

ion

activ

ities

in th

e cu

rren

t rep

ortin

g pe

riod

Show

am

ount

Annu

al w

ork

plan

s, C

CHP/

MTE

EF

Gove

rnm

ent f

und

spen

t on

nutr

ition

Show

am

ount

Coun

cil q

uart

erly

fina

ncia

l rep

ort

Stak

ehol

ders

’ fun

ds sp

ent o

n nu

triti

on in

terv

entio

nsSh

ow

amou

ntQ

uart

erly

stak

ehol

ders

repo

rt

3. I

MPL

EMEN

TATI

ON

OF

ACTI

VITI

ES A

ND

FINA

NCIA

L EX

PEND

ITUR

E (T

otal

of 3

0 po

ints

)

Impl

emen

tatio

n of

the

plan

ned

Nut

ritio

n ac

tiviti

es in

the

repo

rtin

g pe

riod

(5

poin

ts if

ove

r 75%

; 4 p

oint

s if 6

0-<7

5%; 3

poi

nts i

f >50

-<60

%; 2

poi

nts i

f 20-

<50%

; 1

poin

t if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d.5

Coun

cil a

nnua

l rep

ort

Expe

nditu

re V

s allo

cate

d fu

nds f

or th

e di

ffere

nt fu

ndin

g so

urce

s

Gove

rnm

ent f

unds

: (5

poin

ts if

ove

r 75%

; 4 p

oint

s if 6

0-<7

5%; 3

poi

nts i

f >50

-<6

0%; 2

poi

nts i

f 20-

<50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Coun

cil f

inan

cial

repo

rts

Bask

et F

und:

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2

poin

ts if

20-

<50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Coun

cil f

inan

cial

repo

rts

Deve

lopm

ent F

und:

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-

<60%

; 2 p

oint

s if 2

0-<5

0%; 1

poi

nt if

1-<

20%

; and

0 p

oint

s if n

one

impl

emen

ted

5Co

unci

l fin

anci

al re

port

s

OC:

(5 p

oint

s if o

ver 7

5%; 4

poi

nts i

f 60-

<75%

; 3 p

oint

s if >

50-<

60%

; 2 p

oint

s if

20-<

50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Coun

cil f

inan

cial

repo

rt



Oth

er p

artn

ers (

NGO

s)(5

poi

nts i

f ove

r 75%

; 4 p

oint

s if 6

0-<7

5%; 3

poi

nts i

f >50

-<60

%; 2

poi

nts i

f 20-

<50%

; 1 p

oint

if 1

-<20

%; a

nd 0

poi

nts i

f non

e im

plem

ente

d5

Coun

cil f

inan

cial

repo

rts.

4. M

ULTI

-SEC

TORA

L NU

TRIT

ION

COO

RDIN

ATIO

N (T

otal

of 6

0 po

ints

)

Does

the

Coun

cil N

utrit

ion

Mul

tisec

tora

l ste

erin

g co

mm

ittee

exi

st? (

Yes =

10;

No

= 0)

10

Coun

cil’s

Cal

enda

r and

com

mitt

ee m

eetin

gs. L

ette

r of

appo

intm

ent o

f mem

bers

: (TA

MIS

EMI t

o en

sure

Cou

ncils

re

ceiv

e go

vern

men

t circ

ular

on

incl

udin

g st

eerin

g co

mm

ittee

m

eetin

gs in

the

Coun

cil’s

cal

enda

r).

Com

posi

tion

of th

e CM

SCN

con

sist

ent w

ith th

e TO

R? Ye

s (10

); Pa

rtia

l (5)

; No

(0)

10Th

e TO

R, a

ppoi

ntm

ent l

ette

rs

Num

ber o

f mee

tings

con

duct

ed? S

houl

d be

1 e

very

four

mon

ths

10M

inut

es o

f mee

tings

Does

CM

SCN

mee

tings

app

ear i

n Co

unci

l’s c

alen

dar (

Yes =

10

poin

ts; N

o =

0)10

Coun

cil’s

cal

enda

r

Did

the

CMSC

N fo

llow

the

stan

dard

age

nda

as st

ipul

ated

in th

e TO

R an

d di

d ea

ch se

ctor

pre

sent

? (Ye

s = 5

; par

tial =

3 a

nd N

o =

0)5

Invi

tatio

n le

tter

sM

inut

es o

f mee

tings

Wer

e de

cisi

ons a

nd a

ctio

ns a

gree

d an

d re

spon

sibl

e pe

rson

ass

igne

d? (Y

es =

5

poin

ts; N

o =

0)5

Min

utes

of m

eetin

gs

Are

agre

ed a

ctio

ns p

oint

s fol

low

ed u

p at

eac

h m

eetin

g? (Y

es =

5 p

oint

s; N

o 0)

5

Min

utes

of t

he p

revi

ous t

wo

mee

tings

Does

join

t mon

itorin

g su

perv

isio

n in

volv

e st

akeh

olde

rs (C

SO/P

rivat

e se

ctor

et

c.?

5M

onito

ring

supe

rvis

ion

repo

rt

5. L

OGI

STIC

S AN

D SU

PPLI

ESIs

the

nutr

ition

equ

ipm

ent a

nd su

pplie

s dis

trib

utio

n pl

an a

nd lo

gist

ical

ar

rang

emen

t in

plac

e?YE

S/N

ORe

quis

ition

/ord

erin

g ar

rang

emen

ts, d

istr

ibut

ion

Plan

s,

deliv

ery

arra

ngem

ent.

Is th

e av

aila

bilit

y of

ther

apeu

tic fo

ods a

s per

Cou

ncil’

s req

uire

men

t YE

S/N

OPh

ysic

al v

erifi

catio

n, B

NA,

Led

ger b

ook

Is th

e av

aila

bilit

y of

com

bine

d m

iner

als a

nd v

itam

ins a

s per

Cou

ncil

requ

irem

ents

?YE

S/N

O

Is th

e av

aila

bilit

y of

rehy

drat

ion

solu

tion

for m

alnu

triti

on a

s per

Cou

ncil

requ

irem

ents

?YE

S/N

O

Is th

e av

aila

bilit

y of

ferr

ous a

nd fo

lic a

cid

as p

er C

ounc

il re

quire

men

ts?

YES/

NO

Is a

vaila

bilit

y of

vita

min

A a

s per

Cou

ncil

requ

irem

ents

?YE

S/N

O

Is th

e av

aila

bilit

y of

zinc

as p

er C

ounc

il re

quire

men

ts?

YES/

NO

Are

ther

e ad

equa

te a

nd fu

nctio

nal w

eigh

ing

scal

es fo

r inf

ants

?YE

S/N

O

Are

ther

e ad

equa

te a

nd fu

nctio

nal w

eigh

ing

scal

es fo

r und

erfiv

es?

YES/

NO

Are

ther

e ad

equa

te a

nd fu

nctio

nal w

eigh

ing

scal

es fo

r adu

lts?

YES/

NO

Are

ther

e ad

equa

te a

nd fu

nctio

nal M

UAC

tape

s for

eac

h ag

e gr

oup?

YES/

NO

Are

ther

e ad

equa

te a

nd fu

nctio

nal h

eigh

t /le

ngth

boa

rds?

YES/

NO

Are

ther

e ad

equa

te a

nd u

sabl

e Z-

scor

e ch

arts

?YE

S/N

O

Are

ther

e ad

equa

te T

ool k

it/jo

b ai

ds fo

r exa

mpl

e CH

NM

, NAC

S, IY

CF, I

MAM

, DR

NCD

s, g

row

th m

onito

ring

tool

kit?

YES/

NO

6. M

ONI

TORI

NG A

ND E

VALU

ATIO

N (T

otal

40

poi

nts)

Is th

ere

a sy

stem

of M

&E o

f im

plem

enta

tion

of p

lann

ed n

utrit

ion

activ

ities

in th

e re

port

ing

perio

dYE

S/N

OFi

nanc

ial r

epor

t, qu

arte

rly re

port

s, J

MN

R (c

heck

act

iviti

es

impl

emen

ted)

7. M

ONI

TORI

NG A

ND E

VALU

ATIO

NIs

staff

trai

ned

on M

IYCA

N? I

f yes

how

man

y? (C

heck

if tr

aini

ng fo

llow

ed to

ol k

it ac

cord

ing

to th

e ke

y re

sult

area

s of t

he N

MN

AP)

YES/

NO

Num

ber

train

edDN

uO re

port

s/ tr

aini

ng re

port

file

s2

Are

ther

e st

aff tr

aine

d on

MIY

CAN

in th

e re

port

ing

perio

d. If

yes

how

man

y.YE

S/N

ON

umbe

r tra

ined

1

Any

avai

labl

e m

ater

ials

on

10 st

eps t

o su

cces

sful

bre

ast f

eedi

ng?

YES/

NO

Num

ber

train

ed

Phys

ical

ver

ifica

tion

of m

atrix

of 1

0 st

eps t

o su

cces

sful

bre

ast

feed

ing.

2

Is th

ere

any

brea

st-fe

edin

g ed

ucat

ion

happ

enin

g at

ant

enat

al a

nd p

ostn

atal

du

ring

the

visi

t? e

.g. C

are

and

posi

tioni

ng n

ippl

es, a

ttach

men

t, du

ratio

n of

br

east

feed

ing.

YES/

NO

If ye

s,

men

tion

type

of

educ

atio

n

Com

mun

ity a

war

enes

s, h

ealth

and

nut

ritio

n tim

e ta

ble

1

IEC

mat

eria

ls o

n br

east

feed

ing

avai

labl

e?YE

S/N

OPh

ysic

al v

erifi

catio

n - D

ispl

ayed

IEC

mat

eria

ls3

Num

ber o

f mot

hers

or c

areg

iver

s cou

nsel

led

on c

ompl

emen

tary

feed

ing

in th

e re

port

ing

perio

d?Pr

ovid

e nu

mbe

rM

TUH

A, B

NA

DNuO

con

solid

ated

repo

rt3

Num

ber o

f sen

sitiz

atio

n m

eetin

gs/a

dole

scen

ts se

nsiti

zed

on n

utrit

ion

issu

esPr

ovid

e nu

mbe

rsDN

uO re

port

s

IMAM

Are

ther

e st

aff tr

aine

d on

IMAM

. If y

es h

ow m

any?

YES

– pr

ovid

e nu

mbe

r/N

O

Are

ther

e st

affs t

rain

ed o

n N

ACS.

If y

es h

ow m

any?

YES

– pr

ovid

e nu

mbe

r/N

O

Man

agem

ent o

f SAM

offe

red

in h

ealth

faci

litie

s?YE

S/N

OIn

patie

nt S

AM re

gist

ers,

Out

patie

nt S

AM re

gist

ers



Pres

ence

of i

n pa

tient

uni

t?YE

S/N

OPh

ysic

al v

erifi

catio

n

Pres

ence

of S

tore

for n

utrit

ion

supp

lies?

YES/

NO

Pres

ence

of a

room

for p

repa

ring

ther

apeu

tic m

ilk?

YES/

NO

Num

ber o

f SAM

/MAM

chi

ldre

n w

ith H

IV (a

dmitt

ed c

ases

) 0- 5

9 m

onth

s in

the

repo

rtin

g pe

riod

Prov

ide

num

ber

Num

ber o

f SAM

/MAM

chi

ldre

n w

ith H

IV (o

utpa

tient

cas

es) 0

- 59

mon

ths i

n th

e re

port

ing

perio

dPr

ovid

e nu

mbe

r

Num

ber o

f def

aulte

rs’ c

ases

of S

AM/M

AM (i

npat

ient

) 0 -

59 m

onth

s in

the

repo

rtin

g pe

riod

Prov

ide

num

ber

Num

ber o

f def

aulte

rs’ c

ases

of S

AM/M

AM (o

utpa

tient

) 6 -

59 m

onth

s in

the

repo

rtin

g pe

riod

Prov

ide

num

ber

Num

ber o

f cur

ed c

ases

of S

AM 0

- 59

mon

ths i

n th

e re

port

ing

perio

dPr

ovid

e nu

mbe

r

Num

ber o

f SAM

chi

ldre

n di

ed 0

- 59

mon

ths i

n th

e re

port

ing

perio

dPr

ovid

e nu

mbe

r

Num

ber o

f dis

char

ge S

AM c

ases

0- 5

9 m

onth

sPr

ovid

e nu

mbe

r

Are

adm

issi

on a

nd d

isch

arge

crit

eria

follo

wed

? (re

view

IMAM

tool

kit

in a

dvan

ce)

Prov

ide

num

ber

Num

ber o

f chi

ldre

n 6

-59

mon

ths s

cree

ned

with

MUA

C in

the

repo

rtin

g pe

riod

Prov

ide

num

ber

Num

ber o

f mal

nour

ishe

d Ch

ildre

n 6

-59

mon

ths i

dent

ified

with

Oed

ema

in th

e re

port

ing

perio

dPr

ovid

e nu

mbe

r

Num

ber o

f chi

ldre

n 6-

59 m

onth

s with

SAM

refe

rred

for c

linic

al se

rvic

esPr

ovid

e nu

mbe

r

Num

ber o

f chi

ldre

n w

ith M

AM 6

-59

mon

ths r

efer

red

to C

HW

for n

utrit

ion

coun

selli

ngPr

ovid

e nu

mbe

r

Mic

ronu

trie

nts

Num

ber o

f pre

gnan

t mot

hers

who

rece

ived

FEF

O (I

ron-

Fola

te) s

uppl

emen

tatio

nPr

ovid

e nu

mbe

rM

TUH

A 6

Does

the

frequ

ency

and

qua

ntity

of F

EFO

giv

en to

a m

othe

r con

sist

ent w

ith th

e AN

C to

ol k

it?YE

S/N

OPh

ysic

al v

erifi

catio

n of

MTU

HA

6Sam

ple

RCH

car

d 4

Num

ber o

f pos

tnat

al m

othe

rs re

ceiv

ing

the

FEFO

Pr

ovid

e nu

mbe

rM

TUH

A N

o 6

Is c

ouns

ellin

g pr

ovid

ed to

pre

gnan

t mot

hers

bef

ore

give

n th

e FE

FO (e

.g.,

use,

im

porta

nce,

side

effe

cts)

YES/

NO

Phys

ical

ver

ifica

tion

e.g.

Tim

e ta

ble

for c

ouns

elin

g, p

acka

ge o

f co

unse

ling,

sam

plin

g of

pre

gnan

t mot

hers

Do h

ealth

wor

kers

pro

vide

vita

min

A su

pple

men

tatio

n to

chi

ldre

n ac

cord

ing

to

the

tool

kit?

(100

,000

IU fo

r 6 -1

1 m

onth

s, a

nd 2

00,0

00 IU

for 1

2 - 5

9mon

ths)

YES/

NO

MTU

HA

and

CHN

M re

port

s, p

hysi

cal v

erifi

catio

n

Do h

ealth

wor

kers

pro

vide

zinc

and

ORS

to a

ll ch

ildre

n w

ith d

iarr

hea?

YE

S/N

OM

TUH

A (c

heck

No

of th

is b

ook)

If ye

s how

is zi

nc a

nd O

RS a

re p

rovi

ded?

St

ate

how

Phys

ical

ver

ifica

tion

Num

ber o

f chi

ldre

n 12

- 59

mon

ths g

iven

meb

enda

zole

in th

e re

port

ing

perio

dPr

ovid

e nu

mbe

rCH

NM

repo

rts

Wer

e m

icro

nutr

ient

pow

ders

ava

ilabl

e du

ring

the

repo

rtin

g pe

riod?

YES/

NO

MN

Ps re

port

s

Num

ber o

f chi

ldre

n gi

ven

MN

Ps 6

-59

mon

ths i

n th

e re

port

ing

perio

d

Part

icip

atio

n in

nat

iona

l eve

nts/

co

mm

emor

atio

n

CHN

M a

t Cou

ncil

leve

l

Was

CH

NM

exe

rcis

e co

nduc

ted

in J

une/

Dece

mbe

r? If

yes

wha

t was

the

cove

rage

(V

itam

in A

supp

lem

enta

tion,

dew

orm

ing

and

MUA

C sc

reen

ing)

?

Prov

ide

cove

rage

fig

ures

(giv

e 0

if no

t co

nduc

ted

Chec

k CH

NM

repo

rt, M

TUH

A N

o. 7

Are

CHN

M m

icro

pla

ns a

vaila

bilit

y?YE

S/N

O

Wer

e CH

NM

supp

lies e

noug

h?YE

S/N

OCh

eck

the

stoc

k if

any

Brea

stfe

edin

g w

eek

Was

Bre

astfe

edin

g co

unse

lling

con

duct

ed d

urin

g th

e br

east

feed

ing

wee

k?YE

S/N

OCh

eck

brea

stfe

edin

g w

eek

repo

rts

Are

ther

e an

y IE

C m

ater

ials

ava

ilabl

e on

bre

astfe

edin

g?YE

S/N

OPh

ysic

al v

erifi

catio

n

Was

sens

itiza

tion

done

?YE

S/N

OCh

eck

brea

stfe

edin

g w

eek

repo

rts

Grow

th m

onito

ring

Are

ther

e st

aff tr

aine

d on

gro

wth

mon

itorin

g? If

yes

how

man

y?YE

S –

prov

ide

num

ber/

NO

Trai

ning

repo

rt fr

om D

NuO

Are

anth

ropo

met

ric m

easu

rem

ents

take

n, p

lott

ed a

nd in

terp

rete

d pr

oper

ly?

YES/

NO

Data

col

lect

ion

tool

s, p

hysi

cal v

erifi

catio

n RC

H c

ard.



Num

ber o

f chi

ldre

n 0

- 59

mon

ths w

hose

nut

ritio

n st

atus

was

ass

esse

d du

ring

the

repo

rtin

g pe

riod

Prov

ide

num

ber

MTU

HA

No.

7, N

ACs r

egis

ter

Num

ber o

f chi

ldre

n w

ith n

orm

al n

utrit

ion

stat

us in

the

repo

rtin

g pe

riod

Prov

ide

num

ber

Num

ber o

f mod

erat

ely

mal

nour

ishe

d ch

ildre

n in

the

repo

rtin

g pe

riod

Prov

ide

num

ber

Num

ber o

f sev

erel

y m

alno

uris

hed

child

ren

in th

e re

port

ing

perio

dPr

ovid

e nu

mbe

r

Diet

ary

rela

ted

Non-

Com

mun

icab

le

Dise

ase

Are

ther

e cl

inic

s for

non

-com

mun

icab

le d

isea

ses i

n th

e Co

unci

l?YE

S/N

OPh

ysic

al v

erifi

catio

n, N

CD re

gist

er

Is th

ere

any

nutr

ition

edu

catio

n pr

ovid

ed o

n go

od li

fe st

yle

prac

tice

and

non-

com

mun

icab

le d

isea

se?

YES/

NO

Com

mun

ities

aw

aren

ess,

DN

uO c

onso

lidat

ed re

port

Are

heal

th w

orke

rs tr

aine

d on

NCD

s? If

Yes,

how

man

yYE

S/N

O,

prov

ide

num

ber

DNuO

repo

rts

Are

nutr

ition

cou

nsel

ling

and

man

agem

ent o

f ind

ivid

uals

with

DRN

CDs

cond

ucte

dYE

S/N

OCl

ient

regi

ster

s

Nutr

ition

info

rmat

ion

syst

em

Is th

e m

inim

um n

utrit

ion

info

rmat

ion

syst

em p

ract

iced

? (re

fer t

he li

st b

elow

)YE

S/N

O

Phys

ical

ver

ifica

tion

Avai

labi

lity

of la

test

CH

NM

sum

mar

y re

port?

YES/

NO

Avai

labi

lity

of la

test

BN

A re

port?

YE

S/N

O

Avai

labi

lity

of n

utrit

ion

scor

ecar

d?YE

S/N

O

Avai

labi

lity

of J

MN

R re

port?

YE

S/N

O

Avai

labi

lity

of la

test

tech

nica

l nut

ritio

n re

port?

YES/

NO

NAC

S re

gist

ers f

illed

cor

rect

ly?

YES/

NO

Nutr

ition

sens

itive

issu

es

Avai

labi

lity

of n

utrit

ion

sens

itive

inte

rven

tions

in k

ey se

ctor

s: (a

s per

cur

rent

na

tiona

l mul

tisec

tora

l nut

ritio

n ac

tion

plan

): ag

ricul

ture

and

food

secu

rity;

he

alth

and

HIV

; edu

catio

n an

d ea

rly c

hild

hood

dev

elop

men

t; w

ater

, san

itatio

n an

d hy

gien

e (W

ASH

); so

cial

pro

tect

ion;

clim

ate

chan

ge. (

Each

sect

or sh

ould

be

aske

d in

depe

nden

tly)

YES/

NO

for

each

sect

or

men

tione

dM

ultis

ecto

ral N

utrit

ion

Annu

al W

ork

plan

, MTE

F

AGRI

CULT

URE

Prod

uctio

n of

hig

h nu

triti

ve va

lue

crop

sYe

s/N

o

Food

stor

age

and

pres

erva

tion

Docu

men

t m

etho

ds

Crop

Pos

thar

vest

han

dlin

gDo

cum

ent

met

hods

Valu

e ad

ditio

n in

itiat

ives

incl

udin

g fo

od p

roce

ssin

gDo

cum

ent

initi

ativ

es

LIVE

STO

CK a

nd F

ISH

ERIE

S

Valu

e ad

ditio

n in

itiat

ives

(e.g

. in

mea

t/m

ilk)

Docu

men

t

Smal

l ani

mal

/fis

h pr

oduc

tion

Docu

men

t Do

cum

ent

HEA

LTH

AND

HIV

Cove

rage

of p

regn

ant m

othe

rs u

sing

mat

erna

l hea

lth se

rvic

es in

clud

e fa

mily

pl

anni

ng, p

reve

ntio

n an

d tr

eatm

ent o

f HIV

and

mal

aria

serv

ices

.

Prov

ide

cove

rage

fig

ures

MTU

HA,

DRC

HCo

repo

rts

WAT

ER A

ND S

ANIT

ATIO

N W

ASH

Prop

ortio

n of

hou

seho

ld w

ith a

cces

s to

adeq

uate

cle

an a

nd sa

fe w

ater

Prov

ide

prop

ortio

nW

ater

eng

inee

r rep

orts

, Hea

lth O

ffice

r rep

orts

SOCI

AL P

ROTE

CTIO

N

Num

ber o

f poo

rest

hou

seho

lds b

enef

iting

from

TAS

AF’s

cond

ition

al c

ash

trans

fers

in th

e Co

unci

l.Pr

ovid

e nu

mbe

rTA

SAF

coor

dina

tor r

epor

ts, C

omm

unity

dev

elop

men

t offi

cer

repo

rts

Num

ber o

f poo

rest

hou

seho

lds b

enef

iting

from

con

ditio

nal c

ash

trans

fers

who

re

ceiv

ed n

utrit

ion

educ

atio

n du

ring

com

mun

ity se

ssio

ns in

the

Coun

cil.

Prov

ide

num

ber

Tim

e ta

ble,

less

on p

lan,

DN

uO, T

ASAF

EDUC

ATIO

N

Num

ber o

f girl

s enr

olle

d in

seco

ndar

y sc

hool

sPr

ovid

e nu

mbe

rEd

ucat

ion

Offi

cer r

epor

ts

CHIL

D CA

RE D

EVEL

OPM

ENT

(CCD

) AND

EAR

LY C

HIL

DHO

OD

DEVE

LOPM

ENT

(ECD

) INC

LUDI

NG E

ARLY

CH

ILD

STIM

ULAT

ION

Are

ther

e st

aff tr

aine

d on

CCD

/ECD

? If y

es h

ow m

any?

YES/

NO

;pr

ovid

e nu

mbe

rCC

D/EC

D tra

inin

g re

port

Num

ber o

f par

ents

/car

e gi

vers

with

und

er th

ree

year

s old

chi

ldre

n co

unse

lled

on C

CD/E

CD o

n th

e re

port

ing

perio

d in

the

Coun

cil.

Prov

ide

num

ber

CCD/

ECD

Coun

cil’s

repo

rt/D

SWO

repo

rt, D

NU

O re

port



Ap

pen

dix

3:

Nut

riti

on M

onit

orin

g an

d Su

perv

isio

n Ch

eckl

ist f

or fa

cilit

y

Nam

e of

Reg

ion:

……

……

……

……

……

……

……

…...

.

Nam

e of

dis

tric

t: …

……

……

……

……

……

……

……

…

Nam

e of

adm

inis

trat

ive

unit

(Cou

ncil/

War

d/Vi

llage

/etc

.)

Nam

e of

faci

lity:

……

……

……

……

……

……

……

……

……

……

……

……

..

Type

of f

acili

ty (e

.g. h

ealth

, agr

icul

ture

, edu

catio

n, W

ASH

, soc

ial p

rote

ctio

n et

c.)

Date

of s

uper

visi

on: …

……

……

……

……

……

……

……

……

……

……

……

….

AREA

S O

F AS

SESS

MEN

TDE

SCRI

PTIO

NSC

ORE

GU

IDE

MEA

NS

OF

VERI

FICA

TIO

NRE

SPO

NSE

SCO

RERE

MAR

KS/

Actio

n

Hum

an R

esou

rce

How

man

y se

rvic

e pr

ovid

ers a

re in

the

faci

lity?

Pr

ovid

e nu

mbe

rSe

nior

ity li

st

Is th

ere

any

prof

essi

onal

nut

ritio

n off

icer

in th

e fa

cilit

y? If

yes

how

man

y?Ye

s/N

oPr

ovid

e nu

mbe

rSe

nior

ity li

st

Does

nut

ritio

n off

icer

(s) h

ave

an a

ppoi

ntm

ent l

ette

r and

Job

des

crip

tion?

Pers

onal

file

s

Is th

ere

adeq

uate

and

relia

ble

wor

king

spac

e an

d eq

uipm

ent f

or n

utrit

ion

offic

er?

Yes/

No

Offi

ce sp

ace,

tabl

es, c

hairs

and

oth

er w

orki

ng to

ols.

Is th

ere

any

serv

ice

prov

ider

who

is tr

aine

d on

pro

visi

on o

f nut

ritio

n se

rvic

es? I

f ye

s, h

ow m

any?

Yes/

No

Prov

ide

num

ber

Num

ber o

f tra

ined

per

sonn

el (t

rain

ing

book

, file

s)

Plan

ning

and

bud

getin

g fo

r Nu

triti

on

Did

the

faci

lity

plan

for n

utrit

ion

activ

ities

in th

e cu

rren

t fin

anci

al y

ear?

If y

es

(che

ck w

heth

er th

ey co

nfor

m to

NM

NAP

and

chec

k th

e to

tal a

mou

nt b

udge

ted

in

this

qua

rter)

Yes/

No

Chec

k bu

dget

Chec

k pl

an b

ooks

Are

the

faci

lity’s

nut

ritio

n pl

ans i

ncor

pora

ted

into

the

CCH

P? (c

heck

CHO

P)Ye

s/N

och

eck

CHO

P

Are

ther

e an

y pa

rtne

rs su

ppor

ting

nutr

ition

issu

es in

you

r are

a? If

yes

, how

m

any?

Chec

k CH

OP

Are

nutr

ition

par

tner

s’ p

lans

inco

rpor

ated

into

the

faci

lity

plan

s? (a

s an

atta

chm

ent)

Yes/

No

Chec

k pl

an b

ooks

Fina

nces

and

exp

endi

ture

Wha

t is t

he g

over

nmen

t’s c

ontr

ibut

ion

in y

our b

udge

t? (c

heck

sour

ce o

f fun

ds

belo

w)

Stat

e am

ount

Chec

k pl

an b

ooks

Oth

er C

harg

es (O

C)St

ate

amou

nt

Has

you

r fac

ility

con

trib

uted

fund

s to

the

nutr

ition

act

ion

plan

? (O

wn

Sour

ce)

Stat

e am

ount

Loca

l Gov

ernm

ent B

lock

Gra

nt?

Yes/

No

RBF?

Ye

s/N

o

Bask

et F

und?

Yes/

No

Oth

er so

urce

s? (s

peci

fy)

Yes/

No

Did

your

faci

lity

rece

ive

any

fund

for n

utrit

ion

plan

ned

activ

ities

in th

e cu

rren

t fin

anci

al y

ear?

Pr

ovid

e am

ount

Chec

k fin

anci

al re

port

, Pay

men

t Vou

cher

s, R

elea

se

lett

er).

If ye

s, w

hat w

ere

the

key

activ

ities

the

fund

was

use

d fo

r and

how

muc

h w

as

spen

t per

act

ivity

?Ch

eck

finan

cial

repo

rt, P

aym

ent V

ouch

ers,

Rel

ease

le

tter

).

Mul

tisec

tora

l Coo

rdin

atio

nDo

es th

e fa

cilit

y co

ordi

nate

its n

utrit

ion

activ

ities

with

oth

er fa

cilit

ies a

nd th

e M

ultis

ecto

ral s

teer

ing

com

mitt

ee o

n nu

triti

on?

Logi

stic

s and

supp

lies

Are

ther

e an

y pr

oble

ms r

elat

ed to

logi

stic

s and

supp

lies?

Prov

ide

list

If he

alth

faci

lity:

Are

the

orde

ring

proc

edur

es fo

r nut

ritio

n su

pplie

s (FE

FO, v

it A,

m

eben

dazo

le, t

hera

peut

ic fo

od a

nd a

nthr

opom

etric

tool

s) fo

llow

ed?

By lo

okin

g ta

rget

pop

ulat

ion

of e

ach

supp

ly, c

heck

R&

R an

d le

dger

Are

the

nutr

ition

supp

lies r

ecei

ved

as o

rder

ed?

chec

k is

sue

vouc

her,

ledg

er a

nd R

&R

Are

nutr

ition

stoc

ks w

ell m

anag

ed a

nd re

cord

s kep

t? (C

heck

arra

ngem

ent a

nd

reco

rds)

ph

ysic

al v

erifi

catio

n of

R&R

and

ledg

er

Are

ther

e an

y ro

utin

e m

aint

enan

ce p

lans

for a

vaila

ble

tool

s and

equ

ipm

ent?

Ph

ysic

al v

erifi

catio

n of

Fac

ility

pla

n bo

ok

TECH

NICA

L IS

SUES



Mat

erna

l inf

ant y

oung

chi

ld a

nd

adol

esce

nt n

utrit

ion

(MIY

CAN)

1. S

uppo

rt a

nd p

rom

otio

n of

bre

astf

eedi

ng

Are

tool

kit

for M

IYCA

N a

vaila

ble

at th

e fa

cilit

y? (O

PD, R

CH, P

ostn

atal

)ph

ysic

al v

erifi

catio

n

Are

MIY

CAN

job

aids

ava

ilabl

e? (O

PD, R

CH, P

ostn

atal

)ph

ysic

al v

erifi

catio

n

Are

ther

e to

ol k

it an

d jo

b ai

ds fo

r MIY

CAN

from

the

train

ing?

If Ye

s whe

re a

re

they

? ph

ysic

al v

erifi

catio

n

Is

ther

e br

east

feed

ing

educ

atio

n ha

ppen

ing

at a

nten

atal

and

pos

tnat

al d

urin

g th

e vi

sit?

e.g

.. Ca

re o

f nip

ples

, pos

ition

ing

and

atta

chm

ent,

dura

tion

of b

reas

t fe

edin

g le

sson

pre

pare

d an

d tim

e ta

ble,

phy

sica

l ver

ifica

tion

Ar

e IE

C m

ater

ials

on

brea

stfe

edin

g av

aila

ble?

(OPD

, RCH

, Pos

tnat

al)

Indi

cate

whi

chav

aila

bilit

y of

IEC

mat

eria

ls, p

hysi

cal v

erifi

catio

n

2.

Tra

inin

gs o

n M

IYCA

N

Ar

e th

ere

staff

trai

ned

on M

IYCA

N?,

If Ye

s how

man

y?Pr

ovid

e nu

mbe

r C

heck

trai

ning

boo

k, fi

les

Th

e tra

inin

g w

as fo

r how

man

y da

ys?

Phys

ical

ver

ifica

tion

in th

e to

ol k

it

3.

Pro

vide

r pr

actic

es o

n br

east

feed

ing

Is

cou

nsel

ling

on b

reas

t fee

ding

tech

niqu

e do

ne p

rope

rly? (

OPD

, RCH

, Po

stna

tal)

Yes/

No

Phys

ical

ver

ifica

tion

and

prob

e o

n, e

arly

initi

atio

n,

excl

usiv

e br

east

feed

ing,

how

faci

lity

deal

s with

br

east

feed

ing

chal

leng

es

4.

Com

plem

enta

ry F

eedi

ng

Ar

e IE

C m

ater

ials

on

com

plem

enta

ry fe

edin

g av

aila

ble?

(OPD

, RCH

)Ye

s/N

oLi

st th

emPh

ysic

al v

erifi

catio

n

Is

com

plem

enta

ry fe

edin

g co

unse

lling

pro

vide

d to

mot

hers

and

car

egiv

ers?

(O

PD, R

CH, e

tc.),

if y

es, h

ow m

any

have

bee

n co

unse

lled

for r

espe

ctiv

e qu

arte

r?Pr

ovid

e nu

mbe

rPh

ysic

al v

erifi

catio

n: le

sson

pla

n, d

ata

sour

ce to

be

upda

ted

5.

HIV

and

Infa

nt F

eedi

ng

Is

info

rmat

ion,

edu

catio

n an

d co

mm

unic

atio

n (IE

C) m

ater

ials

on

HIV

and

infa

nt

feed

ing

avai

labl

e? (O

PD, R

CH, C

TC, M

ater

nity

war

d)Ye

s/N

o. If

yes

, lis

t m

ater

ials

avai

labi

lity

of IE

C m

ater

ials

, phy

sica

l ver

ifica

tion

Is

nut

ritio

n ed

ucat

ion

bein

g pr

ovid

ed to

mot

hers

and

car

egiv

ers?

(OPD

, RCH

, CT

C, M

ater

nity

war

d)Ye

s/N

o. If

yes

, lis

t se

rvic

esPh

ysic

al v

erifi

catio

n, n

umbe

r of c

areg

iver

. Che

ck,

MTU

HA

If

yes,

wha

t spe

cific

are

as o

f nut

ritio

n ed

ucat

ion

was

pro

vide

d?

List

are

asPh

ysic

al v

erifi

catio

n in

CTC

car

d,

6.

Gro

wth

mon

itori

ng

6.1

Avai

labi

lity

of fu

nctio

ning

mon

itori

ng to

ols

H

ow m

any

wei

ghin

g sc

ales

for I

nfan

ts?

Prov

ide

num

ber

Phys

ical

ver

ifica

tion

for f

unct

iona

lity

and

num

ber

H

ow m

any

wei

ghin

g sc

ale

for u

nder

five

chi

ldre

n?Pr

ovid

e nu

mbe

r

H

ow m

any

wei

ghin

g sc

ale

for a

dults

?N

umbe

r

H

ow m

any

heig

ht/ l

engt

h bo

ards

?N

umbe

r

H

ow m

any

BMI C

hart

s?

H

ow m

any

BMI f

or a

ge c

hart

s?

H

ow m

any

Z-sc

ore

char

ts (W

HO

)?

6.

2 Pr

ovid

er k

now

ledg

e on

ass

essm

ent

Ar

e th

ere

train

ed st

aff o

n gr

owth

mon

itorin

g? If

yes

, how

man

y?N

umbe

rTr

aini

ng b

ook,

file

s

Ar

e th

ere

tool

kit

and

job

aids

for g

row

th m

onito

ring

from

the

train

ing?

Ye

s/N

oPh

ysic

al v

erifi

catio

n

6.

3. P

rovi

der p

ract

ices

on

grow

th m

onito

ring

Ar

e An

thro

pom

etric

mea

sure

men

ts ta

ken,

plo

tted

and

inte

rpre

ted

prop

erly

? Ye

s/N

oPh

ysic

al v

erifi

catio

n, d

ata

colle

ctio

n to

ol

7.

Ser

vice

s Pro

vide

d

Ar

e th

ere

heal

th w

orke

rs tr

aine

d on

IYCF

, NAC

S?N

umbe

rTr

aini

ng re

port

s

H

ow m

any

preg

nant

wom

en h

ave

been

nut

ritio

nally

ass

esse

d an

d cl

assi

fied

in

last

qua

rter

?N

umbe

rN

ACS

regi

ster

H

ow m

any

preg

nant

wom

en h

ave

been

cou

nsel

led

on o

ptim

al n

utrit

ion?

Num

ber

NAC

S re

gist

er

H

ow m

any

mot

hers

of c

hild

ren

0-23

mon

ths h

ave

been

cou

nsel

led

on IY

CF la

st

quar

ter?

Num

ber



7.

Rou

tine

grow

th m

onito

ring

and

pro

mot

ion

for

child

ren

unde

r fiv

eU

nder

five

child

regi

ster

(MTU

HA

7)

If

the

child

has

abn

orm

al g

row

th c

urve

, is h

ealth

wor

ker p

rovi

ding

ade

quat

e ad

vice

to c

are

give

r?

Yes/

No

chec

k th

e re

gist

ers a

nd p

robe

on

how

it is

don

e,

Obs

erve

and

che

ck N

ACS

regi

ster

and

MTU

HA

No.

7

Ar

e th

e w

eigh

ed/m

easu

red

child

ren

bein

g cl

assi

fied

acco

rdin

g to

thei

r nut

ritio

n st

atus

?Ye

s/N

oPh

ysic

al v

erifi

catio

n in

MTU

HA

7

Does

the

faci

lity

offer

SAM

man

agem

ent?

Ye

s/N

oM

TUH

A 5&

11, N

ACS

regi

ster

s, O

PD/IP

D, IM

AM re

gist

er

1.

Infr

astr

uctu

re

Is th

ere

an in

patie

nt U

nit (

War

d) fo

r SAM

?Ye

s/N

oPh

ysic

al v

erifi

catio

n

Is th

ere

a sp

ecia

lized

stor

e/ro

om fo

r SAM

trea

tmen

t pro

duct

s?Ye

s/N

oPh

ysic

al v

erifi

catio

n

2.

Supp

lies (

Phar

mac

y, S

tore

) (Ch

eck

the

avai

labl

e st

ock

com

pare

d to

the

expe

cted

case

s/ re

quir

emen

t)

Is th

ere

suffi

cien

t sto

ck o

f F75

?Ye

s/N

oPh

ysic

al v

erifi

catio

n le

dger

and

R&R

form

s

Is th

ere

suffi

cien

t sto

ck o

f F10

0?Ye

s/N

oPh

ysic

al v

erifi

catio

n le

dger

and

R&R

form

s

Is th

ere

suffi

cien

t sto

ck o

f RU

TF?

Yes/

No

Phys

ical

ver

ifica

tion

ledg

er a

nd R

&R fo

rms

Is th

ere

suffi

cien

t sto

ck o

f Res

omal

?Ph

ysic

al v

erifi

catio

n le

dger

and

R&R

form

s

Is th

ere

suffi

cien

t sto

ck o

f CM

V?Ye

s/N

oPh

ysic

al v

erifi

catio

n le

dger

and

R&R

form

s

3.

Tool

s &Eq

uipm

ent (

Avai

labi

lity,

num

ber

and

func

tiona

lity)

Is th

ere

a fu

nctio

ning

refri

gera

tor(s

) for

SAM

trea

tmen

t pro

duct

s?Ye

s/N

o/N

umbe

rPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

ther

e liq

uid

mea

surin

g ju

gs?

Yes/

No/

Num

ber

Phys

ical

ver

ifica

tion

on a

vaila

bilit

y, fu

nctio

nalit

y an

d nu

mbe

rs.

Is th

ere

a w

atch

?Ye

s/N

o/N

umbe

rPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

ther

e dr

inki

ng c

ups?

Yes/

No/

Num

ber

Phys

ical

ver

ifica

tion

on a

vaila

bilit

y, fu

nctio

nalit

y an

d nu

mbe

rs.

4.

Tool

s &Eq

uipm

ent (

Avai

labi

lity,

num

ber

and

func

tiona

lity)

Is th

ere

a fu

nctio

ning

refri

gera

tor(s

) for

SAM

trea

tmen

t pro

duct

s?Ye

s/N

o/N

umbe

rPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

ther

e liq

uid

mea

surin

g ju

gs?

Yes/

No/

Num

ber

Phys

ical

ver

ifica

tion

on a

vaila

bilit

y, fu

nctio

nalit

y an

d nu

mbe

rs.

Is th

ere

a w

atch

?Ye

s/N

o/N

umbe

rPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

ther

e dr

inki

ng c

ups?

Yes/

No/

Num

ber

Phys

ical

ver

ifica

tion

on a

vaila

bilit

y, fu

nctio

nalit

y an

d nu

mbe

rs.

Are

ther

e jo

b ai

ds a

nd to

ol k

it fo

r SAM

trea

tmen

t?Ye

s/N

oPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Is th

e ea

rly C

hild

hood

Dev

elop

men

t (EC

D) to

ol k

it av

aila

ble?

Yes/

No

Phys

ical

ver

ifica

tion

on a

vaila

bilit

y, fu

nctio

nalit

y an

d nu

mbe

rs.

Are

daily

and

mon

thly

regi

ster

s for

SAM

trea

tmen

t ava

ilabl

e?Ye

s/N

oPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

patie

nt n

utrit

ion

(feed

ing)

card

s ava

ilabl

e?Ye

s/N

oPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

refe

rral f

orm

s ava

ilabl

e?Ye

s/N

oPh

ysic

al v

erifi

catio

n on

ava

ilabi

lity,

func

tiona

lity

and

num

bers

.

Are

MUA

C ta

pes a

vaila

ble?

Yes/

No/

Num

ber

Phys

ical

ver

ifica

tion

on a

vaila

bilit

y, fu

nctio

nalit

y an

d nu

mbe

rs.

5.

Prac

tice

(Rev

iew

IMAM

tool

kit

in a

dvan

ce) (

OPD

, IPD

, RCH

)

Are

the

NAC

S an

d IM

AM to

ol k

it an

d pr

otoc

ols a

vaila

ble?

Yes/

No

Phys

ical

ver

ifica

tion

Are

the

adm

issi

on a

nd d

isch

arge

crit

eria

in tr

eatm

ent (

ITC/

OTC

) fol

low

ed?

(Che

ck a

dmis

sion

and

dis

char

ge fo

rms n

umbe

r pat

ient

s in

last

mon

th, p

robe

to

unde

rsta

nd h

ow c

hild

ren

are

adm

itted

and

dis

char

ged

in O

utpa

tient

The

rape

utic

pr

ogra

m)

Yes/

No

Chec

k IM

AM a

nd N

ACS

regi

ster

s

Is th

ere

refe

rral a

nd re

ferra

l fee

dbac

ks o

f SAM

pat

ient

s fro

m fa

cilit

y to

faci

lity?

Yes/

No

Chec

k re

ferra

l for

ms,

MTU

HA

5, 1

1

6.

Serv

ices

Pro

vide

d



How

man

y ca

ses o

f SAM

/MAM

in c

hild

ren

0-59

mon

ths w

ere

adm

itted

in th

e re

port

ing

perio

d?N

umbe

r

Inpa

tient

s reg

iste

r and

out

patie

nt re

gist

er, N

ACS

How

man

y ca

ses o

f SAM

/MAM

in c

hild

ren

0 - 5

9 m

onth

s wer

e tr

eate

d as

ou

tpat

ient

s in

the

repo

rtin

g pe

riod?

Num

ber

Of t

he S

AM/M

AM c

hild

ren

0- 5

9 m

onth

s who

wer

e ad

mitt

ed (i

n-pa

tient

s) h

ow

man

y w

ere

HIV

pos

itive

in th

e re

port

ing

perio

d?N

umbe

r

Of t

he S

AM/M

AM c

hild

ren

0- 5

9 m

onth

s who

wer

e tr

eate

d as

out

patie

nts,

how

m

any

wer

e po

sitiv

e w

ith H

IV in

the

repo

rtin

g pe

riod?

Num

ber

How

man

y ca

ses o

f SAM

/MAM

inpa

tient

s (ch

ildre

n 0

- 59

mon

ths)

def

aulte

d tr

eatm

ent i

n th

e re

port

ing

perio

d?N

umbe

r

How

man

y ca

ses o

f SAM

/MAM

out

patie

nts (

child

ren

0 - 5

9 m

onth

s) d

efau

lted

trea

tmen

t in

the

repo

rtin

g pe

riod?

Num

ber

How

man

y ch

ildre

n (0

- 59

mon

ths)

with

SAM

wer

e cu

red

in th

e re

port

ing

perio

d?N

umbe

r

How

man

y ch

ildre

n (0

- 59

mon

ths)

with

SAM

die

d du

ring

the

repo

rtin

g pe

riod?

Num

ber

How

man

y ch

ildre

n (0

- 59

mon

ths)

with

SAM

wer

e di

scha

rged

in th

e re

port

ing

perio

d?N

umbe

r

How

man

y ch

ildre

n (0

-59

mon

ths)

with

SAM

wer

e re

ferr

ed fr

om th

e co

mm

unity

to

the

heal

th fa

cilit

y?

Num

ber

How

man

y ch

ildre

n (0

-59

mon

ths)

with

SAM

wer

e re

ferr

ed fr

om th

e he

alth

fa

cilit

y to

the

com

mun

ity?

Num

ber

Chec

k re

ferra

l for

ms

How

man

y ch

ildre

n 6-

59 m

onth

s wer

e sc

reen

ed w

ith M

UAC?

N

umbe

rCH

NM

Rep

ort

How

man

y ch

ildre

n 6-

59 m

onth

s wer

e fo

und

with

oed

ema

durin

g th

e re

port

ing

perio

d?

Num

ber

CHN

M R

epor

t

Diet

Rel

ated

Non

-Co

mm

unic

able

Dis

ease

s (D

RNCD

s)

Are

DRN

CD to

ol k

it av

aila

ble

at th

e fa

cilit

y?

Yes/

No

Phys

ical

ver

ifica

tion

of N

CD to

ol k

it

Are

ther

e H

ealth

Car

e W

orke

r tra

ined

on

DRN

CDs?

Yes/

Num

ber/

No

Trai

ning

boo

k/fil

e

Are

DRN

CDs i

nclu

ded

in n

utrit

ion

educ

atio

n se

ssio

ns?

Yes/

No

Phys

ical

ver

ifica

tion

(less

on p

lan,

tim

e ta

ble)

Is n

utrit

ion

coun

selin

g on

DRN

CD a

nd m

anag

emen

t don

e at

the

faci

lity?

Ye

s/N

oPh

ysic

al v

erifi

catio

n an

d pr

obe

How

man

y cl

ient

s are

rece

ivin

g nu

triti

onal

cou

nsel

ing

and

man

agem

ent o

n DR

NCD

s?N

umbe

rCl

ient

s’ re

gist

ers

Mic

ronu

trie

nt su

pple

men

tatio

n an

d de

wor

min

g

Avai

labi

lity

and

prov

isio

n of

Mic

ronu

trie

nts a

nd d

ewor

min

g (P

harm

acy,

RCH

ledg

ers)

(Che

ck a

vaila

ble

stoc

k co

mpa

re to

the

expe

cted

case

s/re

quir

emen

t)

Does

the

faci

lity

have

suffi

cien

t iro

n/fo

lic a

cid

(FEF

O)?

(den

omin

ator

for

just

ifica

tion

of sc

ore

rank

ing)

Yes/

No

Phys

ical

ver

ifica

tion

Does

the

faci

lity

have

suffi

cien

t vita

min

A (1

00,0

00 IU

and

200

,000

IU)?

(d

enom

inat

or fo

r jus

tific

atio

n of

scor

e ra

nkin

g)Ye

s/N

oPh

ysic

al v

erifi

catio

n, R

&R, a

nd le

dger

Does

the

faci

lity

have

suffi

cien

t zin

c? (d

enom

inat

or fo

r jus

tific

atio

n of

scor

e ra

nkin

g)Ye

s/N

oPh

ysic

al v

erifi

catio

n (in

Dia

rrhe

a Tr

eatm

ent C

orne

r)

Does

the

faci

lity

have

suffi

cien

t ora

l reh

ydra

tion

salt

(ORS

)? (d

enom

inat

or fo

r ju

stifi

catio

n of

scor

e ra

nkin

g)Ye

s/N

oPh

ysic

al v

erifi

catio

n (in

Dia

rrhe

a Tr

eatm

ent C

orne

r)

Does

the

faci

lity

have

suffi

cien

t Meb

enda

zole

? (de

nom

inat

or fo

r jus

tific

atio

n of

sc

ore

rank

ing)

Yes/

No

Phys

ical

ver

ifica

tion

Prac

tice

and

know

ledg

e as

sess

men

t (Po

stna

tal,

RCH

)

Are

preg

nant

mot

hers

giv

en F

EFO

? If Y

es, a

re th

e to

ol k

it fo

llow

ed?

Yes/

No

Chec

k M

TUH

A N

o. 6

and

tool

kit

for F

EFO

Is F

EFO

giv

en to

pos

tpar

tum

mot

hers

? Ye

s/N

oup

date

dat

a so

urce

,

Does

the

heal

th c

are

prov

ider

cou

nsel

the

mot

her b

efor

e gi

ving

FEF

O? (

e.g.

, use

, im

porta

nce,

side

effe

cts)

Yes/

No

Phys

ical

ver

ifica

tion,

less

on P

lan,

tim

etab

le

Does

the

heal

th w

orke

r pro

vide

Vita

min

A to

chi

ldre

n ac

cord

ing

to to

ol k

it?

(100

,000

IU fo

r 6-1

1mon

th, a

nd 2

00,0

00 IU

for 1

2-59

mon

ths)

Ye

s/N

oCh

eck

avai

labi

lity

of to

ol k

it, M

TUH

A N

o. 7

, RCH

1

Card

., ph

ysic

al v

erifi

catio

n

Does

the

heal

th w

orke

r pro

vide

meb

enda

zole

to a

ll ch

ildre

n ro

utin

ely?

(12-

59

mon

ths)

Ye

s/N

oCh

eck

MTU

HA

No.

7, R

HC1

, phy

sica

l ver

ifica

tion

Are

child

ren

6-59

mon

ths s

uppl

emen

ted

with

Vita

min

A?

Yes/

No

CHN

M R

EPO

RT

How

man

y w

omen

rece

ived

iron

/folic

aci

d su

pple

men

ts?

Num

ber

HM

IS, M

TUH

A N

A.6

How

man

y ch

ildre

n 6-

59 m

onth

s wer

e gi

ven

MN

P?N

umbe

rRe

gion

al Im

plem

enta

tion

repo

rt

Child

ren

12-5

9 m

onth

s dew

orm

ed

CHN

M R

EPO

RT



Part

icip

atio

n in

nat

iona

l nu

triti

on re

leva

nt e

vent

s/

com

mem

orat

ion

CHNM

(RCH

)

Was

vita

min

A su

pple

men

tatio

n an

d de

wor

min

g co

nduc

ted

in J

une/

Dece

mbe

r?

Did

you

mee

t 90%

cov

erag

e?Ye

s/N

och

eck

CHN

M re

port

Ye

s/N

o

Wer

e su

pplie

s eno

ugh?

(bas

ing

on re

quire

men

t)Ye

s/N

oCh

eck

the

stoc

k if

any

Brea

stfe

edin

g w

eek

(RCH

)

Was

bre

astfe

edin

g co

unse

lling

con

duct

ed d

urin

g br

east

feed

ing

wee

k?Ye

s/N

oCh

eck

brea

stfe

edin

g w

eek

repo

rts

Are

ther

e an

y IE

C m

ater

ials

ava

ilabl

e on

the

10 st

eps o

f bre

astfe

edin

g?Ye

s/N

oCh

eck

avai

labi

lity

Was

bre

astfe

edin

g se

nsiti

zatio

n do

ne?

Yes/

No

Chec

k br

east

feed

ing

wee

k re

port

s

WAS

HN

utri

tion

sens

itive

issu

es

1.H

ealth

faci

lity

(OPD

, RCH

, Mat

erni

ty)

Is c

lean

and

safe

wat

er a

vaila

ble?

Yes/

No

Phys

ical

ver

ifica

tion

Do th

e he

alth

wor

kers

und

erst

and

the

five

criti

cal t

imes

for h

and

was

hing

? (p

robe

)Ye

s/N

oAv

aila

bilit

y of

SO

P an

d ob

serv

atio

n

Are

the

WAS

H jo

b ai

ds a

nd IE

C m

ater

ials

ava

ilabl

e at

the

faci

lity?

Ph

ysic

al v

erifi

catio

n

2.Ed

ucat

ion

inst

itutio

n

Is c

lean

and

safe

wat

er a

vaila

ble?

Yes/

No

Phys

ical

ver

ifica

tion

Do st

aff a

nd st

uden

ts u

nder

stan

d th

e fiv

e cr

itica

l tim

es fo

r han

d w

ashi

ng?

(pro

be)

Yes/

No

Avai

labi

lity

of S

OP

and

obse

rvat

ion

Are

the

WAS

H jo

b ai

ds a

nd IE

C m

ater

ials

ava

ilabl

e at

the

faci

lity?

Ye

s/N

oPh

ysic

al v

erifi

catio

n

3. C

entr

e fo

r th

e el

derl

y

Is c

lean

and

safe

wat

er a

vaila

ble?

Yes/

No

Phys

ical

Ver

ifica

tion

Do m

embe

rs a

nd c

are

prov

ider

s in

the

cent

re u

nder

stan

d th

e fiv

e cr

itica

l tim

es

for h

and

was

hing

? (pr

obe)

Yes/

No

Avai

labi

lity

of S

OP

and

obse

rvat

ion

Are

the

WAS

H jo

b ai

ds a

nd IE

C m

ater

ials

ava

ilabl

e at

the

faci

lity?

Ye

s/N

oPh

ysic

al V

erifi

catio

n

4.Ch

ildre

n ce

ntre

Are

clea

n an

d sa

fe w

ater

ava

ilabl

e?Ye

s/N

oPh

ysic

al V

erifi

catio

n

Do c

hild

ren

and

care

pro

vide

rs in

the

cent

re u

nder

stan

d th

e fiv

e cr

itica

l tim

es

for h

and

was

hing

? (pr

obe)

Yes/

No

obse

rvat

ion

Ar

e jo

b ai

ds a

nd IE

C m

ater

ials

ava

ilabl

e at

the

faci

lity?

Ye

s/N

oPh

ysic

al V

erifi

catio

n



Feed

ing

prog

ram

s

1.

Hea

lth fa

cilit

y

Does

the

faci

lity

offer

any

food

to in

-pat

ient

s?Ye

s/N

oob

serv

e m

enu,

pre

para

tion

plac

e(ki

tche

n), s

tora

ge

2.

Educ

atio

n in

stitu

tion

Is th

e sc

hool

in th

e sc

hool

feed

ing

prog

ram

sYe

s/N

oPh

ysic

al v

erifi

catio

n on

men

u, p

repa

ratio

n pl

ace(

kitc

hen)

, sto

rage

Are

ther

e an

y fru

its a

nd v

eget

able

gar

den,

smal

l ani

mal

kee

ping

?Ye

s/N

o

3.

Cent

re fo

r th

e El

derl

y

Is th

ere

any

feed

ing

prog

ram

at t

he c

entr

e? S

tatu

sYe

s/N

o

Phys

ical

ver

ifica

tion

on m

enu,

pre

para

tion

plac

e(ki

tche

n), s

tora

ge

Are

ther

e an

y to

ol k

it fo

r eld

erly

feed

ing?

Yes/

No

Are

ther

e an

y fru

its a

nd v

eget

able

gar

den,

smal

l ani

mal

kee

ping

at t

he c

entr

e?Ye

s/N

o

4.

Child

ren

cent

re

Is th

ere

any

feed

ing

prog

ram

at t

he c

entr

e?

Yes/

No

chec

k st

atus

(Phy

sica

l ver

ifica

tion)

Are

ther

e an

y to

ol k

it fo

r Chi

ldre

n fe

edin

g?

Phys

ical

ver

ifica

tion

Are

ther

e an

y fru

its a

nd v

eget

able

gar

den,

smal

l ani

mal

kee

ping

??

NUTR

ITIO

N SU

PPLI

ES

Are

the

wei

ghin

g sc

ales

of i

nfan

ts, u

nder

five

and

adul

ts in

goo

d w

orki

ng

cond

ition

s as p

er n

eeds

at t

he R

egio

nal H

ospi

tal?

Ye

s/N

oPh

ysic

al v

erifi

catio

n

Are

Hei

ght /

leng

th b

oard

s ava

ilabl

e an

d fu

nctio

ning

?Ye

s/N

oPh

ysic

al v

erifi

catio

n

Are

ther

e th

e W

HO

Z sc

ores

cha

rts?

Yes/

No

Phys

ical

ver

ifica

tion

Are

ther

e M

UAC

tape

s for

all

age

grou

ps?

Yes/

No

Phys

ical

ver

ifica

tion

Pres

ence

of t

hera

peut

ic fo

ods,

test

kits

and

med

ical

supp

lies

Is th

ere

suffi

cien

t sto

ck o

f F75

? Ye

s/N

o

Phys

ical

ver

ifica

tion,

Bin

Car

d, L

edge

r boo

ks

(ava

ilabl

e st

ock

com

pare

d to

exp

ecte

d ca

ses)

Is th

ere

suffi

cien

t sto

ck o

f F10

0?Ye

s/N

o

Is th

ere

suffi

cien

t sto

ck o

f RU

TF?

Yes/

No

Is th

ere

suffi

cien

t sto

ck o

f CM

V?Ye

s/N

o

Is t

here

suffi

cien

t sto

ck o

f ReS

oMal

?Ye

s/N

o

Are

iodi

ne te

st k

its a

vaila

ble?

Yes/

No

Phys

ical

ver

ifica

tion

(from

the

Hea

lth O

ffice

r)

Is th

ere

adeq

uate

meb

enda

zole

for c

hild

ren

12 to

59

mon

ths?

Ye

s/N

oPh

ysic

al v

erifi

catio

n, B

in C

ard,

Led

ger b

ooks

(a

vaila

ble

stoc

k co

mpa

red

to e

xpec

ted

case

s)

Pres

ence

of N

utrit

iona

l sup

plem

ents

Is th

ere

suffi

cien

t sto

ck o

f Vita

min

A c

apsu

les?

Yes/

No

Stoc

k ta

king

repo

rt, p

hysi

cal v

erifi

catio

n, in

car

d,

Ledg

er (c

heck

the

avai

labl

e st

ock

com

pare

d to

ex

pect

ed c

ases

)

Is th

ere

suffi

cien

t sto

ck Ir

on-fo

lic a

cid/

(FEF

O)?

Yes/

No

Is th

ere

suffi

cien

t sto

ck Z

inc?

Is th

ere

suffi

cien

t mic

ronu

trie

nt p

owde

r?Ye

s/N

o



Ap

pen

dix

4:

Nut

riti

on M

onit

orin

g an

d Su

perv

isio

n Ch

eckl

ist f

or C

omm

unit

y

Regi

on: …

……

……

……

……

……

……

……

……

……

.

Coun

cil:

……

……

……

……

……

……

……

……

…..

War

d: …

……

……

……

……

……

……

……

……

……

..

Villa

ge/M

taa:

……

……

……

……

……

……

……

……

……

…..

Date

……

……

……

……

……

……

……

……

……

……

..

Area

s of I

nter

vent

ion

Desc

ript

ion

Mea

ns o

f ver

ifica

tion

Resp

onse

Scor

e Re

mar

ks

NU

TRIT

ION

GO

VERN

ANCE

Hum

an R

esou

rce

Avai

labi

lity

of C

HW

/fro

ntlin

ers (

from

oth

er se

ctor

s) in

the

villa

ge/M

taa

Obs

erve

in W

EO/V

EOs O

ffice

Num

ber o

f CH

Ws t

rain

ed o

n nu

triti

on is

sues

train

ing

repo

rts,

vill

age

repo

rts

Num

ber o

f Nut

ritio

n Tr

aini

ngs r

ecei

ved

by C

HW

s Tr

aini

ng re

port

, vill

age

repo

rts

Nam

e of

Inst

itutio

n co

nduc

ted

nutr

ition

trai

ning

Re

port

ing

form

s, tr

aini

ng m

ater

ials

Plan

ning

and

Bud

getin

g

Is n

utrit

ion

inte

grat

ed in

you

r wor

kpla

n? (A

vaila

bilit

y of

wor

k pl

ans t

hat g

uide

th

eir d

aily

impl

emen

tatio

n).

Phys

ical

obs

erva

tion.

(nu

triti

on re

late

d ac

tiviti

es)

Inte

grat

ion

of fr

ontli

ners

’ wor

kpla

ns in

to th

e vi

llage

pla

ns

Villa

ge a

nnua

l pla

ns (n

utrit

ion

rela

ted

activ

ities

)

Logi

stic

s and

Sup

ply

Avai

labi

lity

of w

orki

ng g

ears

pro

vide

d e.

g.. b

icyc

le, r

ain

coat

, gum

boo

ts,

umbr

ella

, bag

etc

.ph

ysic

al v

erifi

catio

n

Cond

ition

of t

he w

orki

ng g

ears

pro

vide

d ph

ysic

al v

erifi

catio

n

TECH

NIC

AL IS

SUES

Mat

erna

l, In

fant

, You

ng

Child

and

Ado

lesc

ent

Nut

ritio

n (M

IYCA

N)

Fron

tline

rs w

ho re

ceiv

ed M

IYCA

N tr

aini

ngTr

aini

ng re

port

, vill

age

repo

rts

Inst

itutio

n co

nduc

ted

train

ing

Repo

rtin

g fo

rms,

regi

ster

s

Num

ber o

f pre

gnan

t wom

en in

the

catc

hmen

t vill

age

of C

HW

Regi

ster

Num

ber o

f lac

tatin

g w

omen

in th

e ca

tchm

ent v

illag

e of

CH

WRe

gist

ers

Num

ber o

f pre

gnan

t wom

en c

ouns

eled

on

MIY

CAN

by

CHW

Atte

ndan

ce li

st, C

HW

regi

ster

s

Num

ber o

f car

egiv

er se

nsiti

zed

on c

ompl

imen

tary

feed

ing.

/mee

ting

cond

ucte

d on

sens

itiza

tion

on m

eetin

g.M

onth

ly re

port

s. /p

robe

Num

ber o

f lac

tatin

g w

omen

cou

nsel

ed o

n ex

clus

ive

brea

st fe

edin

g by

CH

Ws

Atte

ndan

ce li

st, C

HW

regi

ster

s

Num

ber o

f hom

e de

liver

ies r

epor

ted

in a

mon

th in

the

villa

ge b

y CH

Ws,

how

m

any

preg

nant

wom

en h

ave

been

esc

orte

d by

TBA

Mon

thly

repo

rts,

CH

W re

gist

ers

Pres

ence

of h

ome

visi

ting

time

tabl

e to

com

mun

ity fr

ontli

ners

Chec

k fro

ntlin

er ti

met

able

Num

ber o

f hou

seho

lds v

isite

d fo

r pro

mot

ion

of b

ehav

ior c

hang

e in

Nut

ritio

n in

the

last

qua

rter

by

front

liner

sm

onth

ly re

port

s, a

nd q

uart

erly

repo

rts

Nut

ritio

n Su

ppor

t Gro

up

Exis

tenc

e of

nut

ritio

n su

ppor

t gro

ups i

n th

is v

illag

elis

t of g

roup

s. C

HW

Reg

iste

rs

Num

ber o

f nut

ritio

n su

ppor

t gro

ups.

CHW

Reg

iste

rs

Com

posi

tion

of N

utrit

ion

supp

ort g

roup

sBe

nefic

iarie

s reg

iste

rs e

.g..

preg

nant

wom

en, c

are

give

rs, a

dole

scen

ts, m

en, w

omen

, gen

der)

Mal

e pa

rtic

ipat

ion

in th

e nu

triti

on su

ppor

t gro

ups

regi

stra

tion

lists

, phy

sica

l ver

ifica

tion

Num

ber o

f mee

tings

hel

d in

the

last

qua

rter

gr

oup

mee

ting

sche

dule

, att

enda

nce

regi

ster

s,

mee

ting

min

utes

Num

ber o

f sup

port

gro

ups v

isite

d an

d m

essa

ge c

omm

unic

ated

in th

e la

st

quar

ter t

o co

mm

unity

fron

tline

rs, C

HW

sSu

ppor

tive

supe

rvis

ion

repo

rt, p

hysi

cal v

erifi

catio

n

Chal

leng

es n

orm

ally

face

d by

CH

Ws (

aske

d to

fron

tline

r),ch

eck

reco

rds,

min

utes

, pro

bing



Inte

grat

ed M

anag

emen

t of

Sev

ere

Acut

e M

alnu

triti

on (I

MAM

)

Num

ber o

f all

front

liner

s tra

ined

on

Nut

ritio

n Sc

reen

ing

part

icip

ants

list

, rep

orts

Avai

labi

lity

of jo

b ai

dsph

ysic

al v

erifi

catio

n

Num

ber o

f chi

ldre

n sc

reen

ed fo

r mal

nutr

ition

in th

e M

onth

:

a. N

orm

al n

utrit

ion

stat

usM

onth

ly re

port

s

b. M

oder

ate

mal

nutr

ition

Mon

thly

repo

rts

c. S

ever

e ac

ute

mal

nutr

ition

Mon

thly

repo

rts

Num

ber o

f chi

ldre

n re

ferr

ed b

y CH

W to

the

heal

th fa

cilit

ies f

or m

alnu

triti

onre

ferra

l for

ms

Fee

dbac

k re

ceiv

ed fr

om th

e he

alth

faci

lity

(Yes

/No)

chec

k fe

edba

ck re

ferra

l for

ms

Mea

ns o

f rec

eivi

ng fe

edba

ck fr

om h

ealth

faci

litie

sch

eck

feed

back

refe

rral f

orm

s, C

HW

repo

rts

Follo

w-u

ps c

ondu

cted

to th

e ho

useh

olds

for m

alnu

triti

on c

ases

repo

rts

Mul

tisec

tora

l Nut

ritio

n Se

nsiti

ve In

terv

entio

ns1.

Ag

ricu

lture

/Liv

esto

ck

Num

ber o

f hou

seho

lds w

hich

pra

ctic

e ho

me

gard

enin

g an

d sm

all a

nim

al

keep

ing

(ask

fron

tline

rs)

Mon

thly

repo

rts

Num

ber o

f hou

seho

ld se

nsiti

zed

on se

curin

g di

vers

e fo

ods (

eith

er th

roug

h ow

n pr

oduc

tion,

buy

ing

or e

ven

thro

ugh

soci

al in

tera

ctio

n) (a

sk fr

ontli

ners

)M

onth

ly re

port

s

2.

Wat

er, S

anita

tion

and

Hyg

iene

(WAS

H)

CHW

s rec

eive

d tra

inin

g on

WAS

H#

of d

ays a

tten

ded

the

train

ing

Sens

itiza

tion

mee

ting

done

on

WAS

H b

y w

hom

Prob

e, se

nsiti

zatio

n re

port

s

Num

ber o

f hou

seho

lds h

ave

func

tiona

l han

dwas

hing

with

soap

faci

lity

mon

thly

repo

rts,

sele

ct ra

ndom

ly

Prop

ortio

n of

hou

seho

ld a

cces

sing

cle

an a

nd sa

fe w

ater

spot

che

cks,

pro

bing

, phy

sica

l ver

ifica

tion

Prop

ortio

n of

Hou

seho

lds w

ith im

prov

ed la

trin

es

phys

ical

ver

ifica

tion

3.

CCD

/ECD

Fron

tline

rs re

ceiv

ed tr

aini

ng o

n CC

D/EC

DTr

aini

ng m

ater

ials

, rep

orts

, job

aid

s, p

robe

, obs

erve

co

mm

unic

atio

n sk

ills,

CH

W se

nsiti

zatio

n re

port

s.

Pare

nts a

nd o

ther

car

egiv

ers d

o ac

tions

to st

imul

ate

the

child

righ

t fro

m

conc

eptio

n (e

.g. s

ingi

ng, t

ellin

g st

orie

s, p

layi

ng w

ith th

em, i

mita

ting

thei

r so

unds

and

wor

ds)

Obs

erve

par

ents

/ car

egiv

ers’

inte

ract

ion

with

chi

ldre

n

Are

ther

e pl

ayin

g m

ater

ials

for k

ids u

sing

loca

lly a

vaila

ble

mat

eria

ls?

Obs

erve

pre

senc

e of

pla

ying

mat

eria

ls

4.

Soci

al p

rote

ctio

n th

roug

h Ta

nzan

ia S

ocia

l Act

ion

Fund

(TAS

AF)

Num

ber o

f poo

rest

hou

seho

lds b

enef

iting

from

TAS

AF C

ash

Tran

sfer

s in

the

villa

ge

List

of b

enef

icia

ries

Num

ber o

f poo

rest

hou

seho

lds b

enef

iting

from

TAS

AF C

ash

Tran

sfer

s tha

t ha

ve re

ceiv

ed n

utrit

ion

coun

selin

g

regi

stra

tion

form

, les

son

plan

Wor

king

Too

ls &

Eq

uipm

ent

Avai

labi

lity

of jo

b ai

ds a

nd to

ol k

it to

fron

tline

rsCh

eck

the

avai

labi

lity

of jo

b ai

ds a

nd to

ol k

it

Avai

labi

lity

of d

aily

and

mon

thly

regi

ster

s Ch

eck

avai

labi

lity

of re

gist

ers

Avai

labi

lity

of re

ferra

l for

ms

Chec

k av

aila

bilit

y of

refe

rral f

orm

s

Avai

labi

lity

of n

utrit

ion

scre

enin

g to

ols (

MUA

C Ta

pes,

wei

ghin

g sc

ale,

etc

. Ch

eck

avai

labi

lity

of th

e sc

reen

ing

tool

s

Bene

ficia

ries

(pre

gnan

t w

omen

, lac

tatin

g w

omen

, men

, wom

en,

child

ren,

eld

erly

). Ta

ke

sam

ple

acco

rdin

g to

the

grou

p of

ben

efic

iari

es

Nut

ritio

n ad

vice

rece

ived

in th

e la

st 3

mon

ths

Chec

k th

e un

ders

tand

ing

of th

e co

nten

t am

ong

the

bene

ficia

ries

Type

of a

dvic

e re

ceiv

ed

Are

bene

ficia

ries p

rovi

ded

with

ade

quat

e an

d fu

nctio

nal i

nfor

mat

ion

on

nutr

ition

?



Awar

enes

s of n

utrit

ion

supp

ort g

roup

Parti

cipa

tion

in n

utriti

on su

ppor

t gro

up

Bene

fit o

btai

ned

from

nut

ritio

n su

ppor

t gro

up

Nut

ritio

n ed

ucat

ion

rece

ived

from

hea

lth p

rovi

ders

at t

he h

ealth

faci

lity

chec

k th

e un

ders

tand

ing

of th

e un

ders

tand

ing

of

cont

ent

Nut

ritio

n ed

ucat

ion

rece

ived

from

the

CHW

sCh

eck

evid

ence

of t

he su

pple

men

t pro

vide

d

Supp

lem

ent r

ecei

ved

from

the

heal

th fa

cilit

yRC

H c

ard

num

ber 1

and

4

Obs

erva

tion,

RCH

car

d

Ap

pen

dix

5:

Nut

riti

on M

onit

orin

g an

d Su

perv

isio

n Ch

eckl

ist f

or P

riva

te s

ecto

r

Regi

on: …

……

……

……

……

……

……

……

……

……

.

Coun

cil:

……

……

……

……

……

……

……

……

…..

Date

……

……

……

……

……

……

……

……

……

……

..

Area

s of I

nter

vent

ion

Desc

ript

ion

Mea

ns o

f ve

rific

atio

nRe

spon

seSc

ore

Rem

arks

Nam

e of

org

aniz

atio

n:…

……

……

…...

......

......

......

......

......

......

......

......

......

......

......

.……

….

Type

of o

rgan

izat

ion:

Dea

ling

with

……

……

……

......

......

......

......

......

......

......

......

..……

….

Cert

ifica

te o

f inc

orpo

ratio

n: …

……

……

……

……

……

…...

......

......

......

......

......

......

......

......

.

Area

s of a

sses

smen

tDe

scrip

tion

Tota

l Sco

re M

eans

of v

erifi

catio

n R

espo

nse

Sco

reRe

mar

ks

Hum

an R

esou

rce

for

Nut

ritio

n (T

otal

of 3

0 po

ints

)Pr

esen

ce o

f a p

erso

n w

ith a

pro

fess

ion

rele

vant

to n

utrit

ion

in th

e or

gani

zatio

n/fir

m10

Hum

an R

esou

rce

data

base

/cer

tific

ates

Is th

ere

any

tool

kit

for p

rodu

ctio

n pr

oces

s?

5Av

aila

bilit

y of

mot

ivat

ion

pack

age

e.g.

tim

ely

sala

ry p

aym

ent,

cond

uciv

e w

orki

ng e

nviro

nmen

t, re

sult

of si

mpl

e el

ectr

onic

su

rvey

, bre

ast f

eedi

ng C

onne

r, ba

by c

are

site

s,

5M

edic

al e

xam

inat

ion

plan

and

repo

rt

5O

rient

atio

n re

port

5Ph

ysic

al v

erifi

catio

n

Plan

ning

and

bud

getin

g fo

r N

utri

tion

(Tot

al o

f 10

poin

tsAr

e th

ere

plan

ned

activ

ities

on

nutr

ition

?5

Firm

pla

nnin

g do

cum

ent

5Av

aila

bilit

y of

cor

pora

te so

cial

resp

onsi

bilit

y re

port

/rec

ords



Logi

stic

s and

supp

lies

(Tot

al o

f 20

poin

ts)

Avai

labi

lity

of w

orki

ng g

ears

and

con

ditio

n of

wor

king

gea

rs5

Phys

ical

ver

ifica

tion.

Adeq

uate

spac

e fo

r equ

ipm

ent a

nd st

orag

e of

mat

eria

ls5

Stor

age

and

hand

ling

cond

ition

s5

Vent

ilatio

n of

the

prem

ise

Tech

nica

l iss

ues

(Tot

al 3

5 po

ints

)Is

Haz

ard

anal

ysis

crit

ical

con

trol

poi

nt sy

stem

adh

ered

to: -

e.g

. raw

mat

eria

ls,

rece

ptio

n, p

repa

ratio

n, st

orag

e, p

roce

ssin

g/ha

ndlin

g?10

Phys

ical

ver

ifica

tion

Avai

labi

lity

of sa

nita

tion

syst

em: c

lean

and

safe

wat

er, s

ewag

e sy

stem

and

was

te

disp

osal

mec

hani

sm.

6

Are

the

food

pro

duct

s ade

quat

ely

forti

fied?

4Pr

esen

ce o

f pre

mix

es, a

vaila

bilit

y of

dos

ifier

s/m

ixin

g de

vice

s,

labe

l, te

st k

its

Qua

lity

assu

ranc

e la

bora

tory

5Ph

ysic

al v

erifi

catio

n

Is p

acka

ging

and

labe

lling

stan

dard

s adh

ered

to?

5Ph

ysic

al v

erifi

catio

n as

per

regu

latio

n

Is th

ere

any

stan

dard

ope

ratin

g pr

oced

ures

?5

Phys

ical

ver

ifica

tion

Ap

pen

dix

6:

Supe

rvis

ion

Chec

klis

t: Fo

r N

GOs,

CBO

s an

d FB

Os

at N

atio

nal,

Regi

onal

, Cou

ncil

and

Com

mun

ity

leve

ls

Regi

on: …

……

……

……

……

……

……

……

……

……

Coun

cil:

……

……

……

……

……

……

Stre

et/P

lot n

umbe

r ……

……

……

……

……

……

……

……

Nam

e of

the

NGO

/CBO

/FBO

: ……

……

……

……

……

……

……

.

Date

of s

uper

visi

on: …

……

……

…

Area

s of a

sses

smen

tDe

scri

ptio

nM

eans

of v

erifi

catio

nRe

spon

seSc

ore

Rem

arks

Chec

k th

e: -

Regi

stra

tion

Is y

our o

rgan

izatio

n re

gist

ered

?Ce

rtifi

cate

of R

egis

tratio

n

Scop

e of

wor

k

Do th

e nu

triti

on in

terv

entio

ns im

plem

ente

d by

yo

ur o

rgan

izatio

n re

flect

ed in

the

MoU

?An

nual

wor

k pl

an im

plem

enta

tion

Wha

t is y

our t

arge

t gro

ups?

Proj

ect d

ocum

ent/

prop

osal

Wha

t is t

he c

over

age

of y

our n

utrit

ion

inte

rven

tions

?Pr

ojec

t doc

umen

t/pr

opos

al

Who

are

you

r im

plem

entin

g pa

rtne

rs?

Mem

oran

dum

of U

nder

stan

ding

/Pr

ojec

t doc

umen

t

Hum

an R

esou

rces

Avai

labi

lity

of h

uman

reso

urce

s fo

r nut

ritio

n an

d ot

her r

elat

ed d

isci

plin

esH

uman

Res

ourc

e da

taba

se

Plan

ning

and

Bud

getin

g

Is y

our g

ener

al p

lan

inte

grat

ed in

to th

e an

nual

go

vern

men

t pla

n (M

TEF)

? M

TEF

Nut

ritio

n Co

ordi

natio

n

Awar

enes

s and

par

ticip

atio

n in

the

mul

tisec

tora

l st

eerin

g co

mm

ittee

on

nutr

ition

N

utrit

ion

Stee

ring

com

mitt

ee

mee

ting

min

utes

Do y

ou p

lan

your

supp

ortiv

e su

perv

isio

n to

geth

er

with

the

Gove

rnm

ent?

Supp

ortiv

e su

perv

isio

n pl

ans a

nd

repo

rts

Do y

ou c

ondu

ct a

join

t sup

port

ive

supe

rvis

ion

with

Gov

ernm

ent (

Regi

onal

/Cou

ncil

Offi

cial

s)?

Supe

rvis

ion

repo

rt

Do y

ou p

artic

ipat

e an

d su

ppor

t com

mem

orat

ion

of n

utrit

ion

even

ts e

.g. C

hild

Hea

lth a

nd N

utrit

ion

Mon

th, W

orld

Bre

astfe

edin

g W

eek?

Com

mem

orat

ion

repo

rts

Do y

ou sh

are

impl

emen

tatio

n re

port

s with

Go

vern

men

t?

Impl

emen

tatio

n re

port

and

co

verin

g le

tter



Ap

pen

dix

7:

List

of p

arti

cipa

nts

who

dev

elop

ed th

e su

ppor

tive

supe

rvis

ion

tool

kit

.

Tabl

e 1:

PAR

TICI

PAN

TS W

HO D

EVEL

OPE

D FI

RST

DRAF

T DU

RIN

G C

HECK

LIST

WO

RKSH

OP,

MO

ROG

ORO

, Aug

ust 2

1-25

, 201

7

SNN

AME

POSI

TIO

NIN

STIT

UTI

ON

1Tu

mai

ni M

ikin

doLe

ad F

acili

tato

r (ED

)PA

NIT

A

PO -

RALG

2ST

EPH

EN M

OTA

MBI

ADN

SPO

-RAL

G

3M

WIT

A J.

M. W

AIBE

NuO

PO-R

ALG

4M

ARIA

M N

AKU

WA

NuO

PO-R

ALG

5M

AGES

A JA

PHAR

IN

uOPO

-RAL

G

6ZU

HU

RA K

ARYA

PSW

OPO

-RAL

G

7JE

REM

IAH

MW

AMBA

NGE

NuO

PO-R

ALG

MIN

ISTR

IES,

DEP

ARTM

ENTS

AND

AGE

NCIE

S (M

DA)

8RA

YA M

. HAS

SAN

NuO

PEM

BA N

U-U

NIT

9PE

TER

KASW

AHIL

IN

uOM

OH

CDGE

C

10FR

ANCI

S M

ODA

HA

SRO

TFN

C

11AD

AM H

ANCY

RO -

Stat

istic

sTF

NC

12AS

HA

H. S

ALM

INN

uON

UTR

ITIO

N U

NIT

MO

H-Z

NZ

NUTR

ITIO

N O

FFIC

ERS

AT R

EGIO

NAL

AND

COUN

CIL

LEVE

LS

13RI

ZIKI

MBI

LIN

YIN

uOSU

MBA

WAN

GA R

RH

14EL

INA

KWEK

AM

NuO

MO

ROGO

RO M

UN

ICIP

AL C

OU

NCI

L

15PR

OSP

ER M

. MU

SHI

RNuO

RS-A

RUSH

A

16PR

ISCA

SH

IRAT

IDN

uOBU

TIAM

A DC

17DO

RICE

R. M

UN

ISI

NuO

RS-K

ILIM

ANJA

RO

18BE

RTH

A D.

MW

AKAB

AGE

DNuO

MU

HEZ

A DC

19.

TILI

ZA M

BULL

ADN

uOIR

INGA

-DC

20AS

IATU

H. M

BWAM

BODN

uOM

PWAP

WA-

DC

21.

AMAN

I MW

AKIP

ESIL

EM

NuO

MBE

YA C

C

22.

BERT

HA

NYI

GURN

uORS

-NJO

MBE

23.

NEE

MA

KWEB

ADN

uOM

LELE

DE-K

ATAV

I

24.

ANN

A AN

DREW

DNuO

LON

GIDO

-DC

25.

RACH

EL C

ASM

IRY

NuO

RRH

- PW

ANI

26.

NAO

MI A

. RU

MEN

YELA

MN

uOKI

GOM

A/UJ

IJI

27.

FEST

O S

. TIL

IAN

uOM

ERU

28.

JAN

ET M

NZA

VARN

uORS

-DAR



CSO

s, F

BO

29N

ORB

ERT

MAS

SAY

Proj

ect M

anag

erPA

CT-T

Z

30EL

IA M

SEGU

Proj

ect M

anag

erAM

NET

(HI)

31N

EEM

A LA

ZARO

Proj

ect M

anag

erCU

AMM

-NJO

MBE

UNIT

ED N

ATIO

NS

32.

DIVY

A N

ARAY

ANBC

G/TF

NC

Tabl

e 2:

PAR

TICI

PAN

TS W

HO D

EVEL

OPE

D DR

AFT

2 O

F CH

ECKL

IST

DURI

NG

TAS

K FO

RCE

WO

RKSH

OP

HELD

AT

MIP

ANG

O H

OU

SE D

ODO

MA,

OCT

OBE

R 30

TH –

NO

VEM

BER

3RD

2017 No

NAM

EPO

SITI

ON

INST

ITU

TIO

N

1DR

. FES

TO K

AVIS

HE

Lead

Fac

ilita

tor

Cons

ulta

nt/U

NIC

EF

PO-R

ALG

2M

WIT

A J.

M. W

AIBE

NuO

PO-R

ALG

3M

ARIA

M N

AKU

WA

NuO

PO-R

ALG

4FE

STO

S. T

ILIA

NuO

PO-R

ALG

5M

AGES

A JA

PHAR

IN

uOPO

-RAL

G

6PR

OSP

ER M

. MU

SHI

NuO

PO-R

ALG

7ST

EPH

AN J

. MO

TAM

BIAD

NS

PO-R

ALG

8JE

REM

IAH

H. M

WAM

BAN

GEN

uOPO

-RAL

G

NUTR

ITIO

N O

FFIC

ERS

AT R

EGIO

NAL

AND

COUN

CIL

LEVE

LS

9N

EEM

A A.

KW

EBA

DNuO

Mle

le D

C

10TI

LIZA

MBU

LLA

DNuO

Iring

a DC

11BE

THA

NYI

GURN

uON

jom

be R

S

12DE

NN

IS M

ADEL

EKE

RNuO

Shin

yang

a RS

MIN

ISTR

IES,

DEP

ARTM

ENTS

AND

AGE

NCIE

S (M

DA)

13AD

AM H

ANCY

R.O

- St

atis

tics

TFN

C

14AL

OYC

E H

. KW

AYP/

Econ

omis

tPM

O

15FR

ANCI

S M

ODA

HA

Snr.

R.O

TFN

C

16PE

TER

KASW

AHIL

IN

uOM

OH

CDGE

C

CSO

s, F

BO

17JO

SEPH

L. M

UGY

ABU

SORE

G. N

UT.

CO

ORD

INAT

OR-

ASTU

TEIM

A W

orld

Hea

lth

18TU

MAI

N M

IKIN

DOEX

ECU

TIVE

DIR

ECTO

RPA

NIT

A

19SY

LVES

TER

NAN

DISP

ON

I-TZ

20H

ADIJ

A H

ALID

ICU

AMM

21DO

ROTH

Y M

SIM

BIRA

AFRI

CARE

– M

WAN

ZO B

ORA

UNIT

ED N

ATIO

NS

22H

ELEN

WES

TCo

nsul

tant

WFP

/BCG

23FE

RGU

S H

AMILT

ON

Cons

ulta

ntW

FP



Tabl

e 3:

PAR

TICI

PAN

TS A

T VA

LIDA

TIO

N W

ORK

SHO

P, H

ELD

AT M

IPAN

GO

HO

USE

, DO

DOM

A, 1

3-15

NO

VEM

BER

2017

AN

D TH

OSE

WHO

SEN

T em

ail C

OM

MEN

TS B

UT

COU

LD N

OT

PART

ICIP

ATE

IN M

EETI

NG

S/N

Nam

ePo

sitio

nIN

STIT

UTI

ON

1DR

. FES

TO K

AVIS

HE

LEAD

FAC

ILIT

ATO

RIN

DEPE

NDE

NT

CON

SULT

ANT

PO-R

ALG

2M

WIT

A J.

M. W

AIBE

NuO

PORA

LG

3ST

EPH

EN J

. MO

TAM

BIAD

NS

PORA

LG

4M

AGES

A JA

PHAR

IN

uOPO

RALG

5M

ARIA

M N

KUM

BWA

SWO

PORA

LG

6FE

STO

S. T

ILIA

N

uOPO

RALG

7ZA

INAB

U K

ITEM

BESW

OPO

RALG

8JE

REM

IAH

H. M

WAM

BAN

GEN

uOPO

RALG

9PR

OSP

ER M

. MU

SHI

NuO

PORA

LG

10ZU

HU

RA H

. KAR

YAPS

WO

PORA

LG

MIN

ISTR

IES,

DEP

ARTM

ENTS

AND

AGE

NCIE

S (M

DAs)

11PE

TER

KASW

AHIL

IN

uOM

OH

CDGE

C

12FR

ANCI

S M

ODA

HA

SEN

. RES

EARC

H O

FFIC

ER

TFN

C

13SA

MSO

N M

APU

NDA

ECO

NO

MIS

TM

oFP

14AL

OYC

E H

. KW

AY

PRIN

CIPA

L EC

ON

OM

IST

PMO

15M

ARGA

RET

NAT

AIN

UTR

ITIO

N F

OCA

L PO

INT

MO

A

REGI

ONA

L AN

D DI

STRI

CT/C

OUN

CIL/

TOW

N NU

TRIT

ION

OFF

ICER

S

16M

ARIA

M A

THU

MAN

IRN

uORS

DO

DOM

A

17AN

NA

ANDR

EWRN

uORS

ARU

SHA

18M

WAN

AMVU

A ZU

BERI

RNU

ORS

-TAN

GA

19H

APPY

M. M

OSE

SRN

uORS

MO

ROGO

RO

20H

ERIE

TH K

IPU

YORN

uOM

TWAR

A

21TH

EDA

SIN

DERN

uOSI

NGI

DA

22JA

NET

ALL

AN M

ZAVA

RNuO

DAR

ES S

ALAA

M

23JO

SEPH

INE

SWAI

RNuO

KILI

MAN

JARO

24RE

HEM

A N

APEG

WA

RNuO

TABO

RA

25CH

ACH

A M

AGIG

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uOSI

MIY

U

26AS

NAT

H M

REM

ARN

uOKA

TAVI

27PA

MEL

A M

EEN

ARN

uOPW

ANI

28LE

WIS

MAH

EMBE

RNuO

MBE

YA

29PA

UL

MAK

ALI

RNuO

KAGE

RA

30M

ARY

BON

AVEN

TURE

RNuO

DODO

MA

31AL

ICE

KIPA

NGA

RNuO

RUKW

A



32N

EEM

A M

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TAN

uOIR

INGA

-RRH

33EU

GEN

IA K

OM

BEO

NuO

SON

GEA

RRH

34RI

ZIKI

I. M

BILI

NYI

NuO

RS R

UKW

A

35W

INIF

RIDA

CH

ACH

ADN

uOSI

MAN

JIRO

DC

36H

AFSA

H. P

ON

GWE

DNuO

SON

GWE

DC

37CH

RIST

INA

HEN

JEW

ELE

TNuO

BARI

ADI T

C

38ID

RISA

ABD

IDN

uOM

BULU

DC

39EM

MA

KILI

MAL

IN

uOM

WAN

ZA C

C

40IM

ACU

LATE

KAL

OLO

DNuO

KWIM

BA D

C

41ES

TER

SHAB

ODN

uOM

BOGW

E DC

42VE

RON

ICA

BALU

WA

DNuO

KILW

A DC

43FR

IDA

MU

HIN

DIDN

uOM

BOZI

DC

44PR

ISCA

SH

IRAT

IDN

uOBU

TIAM

A DC

45N

AOM

I LU

MEN

YELA

DNuO

KIGO

MA

UJIJ

I (M

C)

UN

ITED

NAT

ION

S AG

ENCI

ES

46JO

YCE

NGE

GBA

NU

TRIT

ION

SPE

CIAL

IST

UN

ICEF

47M

AURO

BRE

RON

UTR

ITIO

N S

PECI

ALIS

TU

NIC

EF (b

y em

ail)

48N

EEM

A SH

OSH

ON

uOW

FP

DEVE

LOPM

ENT

PART

NERS

49TE

MIN

A M

KUM

BWA

NU

TRIT

ION

CO

ORD

INAT

OR

USA

ID T

ANZA

NIA

(By

emai

l)

50CH

IHO

SU

ZUKI

SEN

. HEA

LTH

SPE

CIAL

IST

THE

WO

RLD

BAN

K (B

y em

ail)

51YI

-KYO

UN

G LE

E H

EALT

H, N

UTR

ITIO

N &

PO

PULA

TIO

N

EAST

ERN

& S

OU

THER

N A

FRIC

A RE

GIO

NTH

E W

ORL

D BA

NK

(By

emai

l)

52EL

LA V

ICTO

RIA

HU

MPH

RYTH

E W

ORL

D BA

NK

(By

emai

l)

CSO

/NGO

S

53JO

SEPH

K.L

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THE UNITED REPUBLIC OF TANZANIA · 2018-07-09 · THE UNITED REPUBLIC OF TANZANIA FOR COMPREHENSIVE...

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