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The CSP was aligned with national policies on food and nutrition security. It focused on nutrition specific elements such as Moderate and Acute Malnutrition (MAM) and Social and Behaviour Change Communication (SBCC) with limited preventive activities beyond behaviour change and no clear linkages with nutrition sensitive interventions. While partnerships were recognized as ¡® central¡¯, the CSP did not focus on the strategic role of partners in leveraging Â鶹ÊÓƵ¡¯s own efforts and in ensuring a more multisectoral approach to malnutrition. The Country Office (CO) collaborated with a number of United Nations agencies including UNICEF on MAM, the WHO on child and adolescent health, and FAO on food security coordination. However, United Nations System wide coherence with the government was not fully achieved. This was partly due to frequent changes in the government, but also to a lack of mechanisms for regular dialogue and accountability

Targeted supplementary food assistance: While targets for training, and the number of people exposed to nutrition messaging, were met or exceeded the CSP did not reach its targets for provision of fortified and specialized nutritious foods in 2018 and 2019. Both these Targeted Support Feeding Programme (TSFP) elements were severely underfunded. At outcome level, performance data showed challenges in relation to MAM treatment default and recovery rates, as well as child coverage. Larger proportions of MAM patients defaulted from both treatment and recovery than planned. Strengthening of national capacities to sustainably deliver food, nutrition and supply chain services. Target achievement at the output level varied greatly, with indicators mainly focused on training events and the provision of technical assistance, thus not reflecting the full spectrum of Â鶹ÊÓƵ engagement in the country. In fact, successful advocacy of government funding for nutrition supplies was an achievement not captured by the results framework. A rice fortification pilot study led to the formation of a technical Working Group under the Ministry of Agriculture and Fisheries and the drafting of a law on food fortification. The ¡®Fill the Nutrient Gap¡¯ study built awareness of key nutrition issues and was used to inform the 2019 UN Common Country Analysis. Systems and procedures of the medical supply chain were strengthened at central level, but Â鶹ÊÓƵ underestimated the scale of the challenge in terms of the depth, quality, and duration of the structural and procedural changes needed, and the skills that Â鶹ÊÓƵ staff required.

Gender Equality and Women¡¯s Empowerment. Â鶹ÊÓƵ made notable progress in generating evidence of, and advocating attention to, the nutrition needs of adolescent girls. However, more women than men were reached by nutrition messages suggesting that there is a need for further outreach to men and boys. Sustainability. There are technical and financial challenges to sustainability, mainly concerning handover of the TSFP coordination functions from Â鶹ÊÓƵ to the Ministry of Health. The resources provided for TSFP were insufficient, capacity strengthening is yet to be consolidated, and facilities were struggling with reduced quantities, and regularity of distribution of supplies at the field level.

Cost-effectiveness of the TSFP increased under the CSP and compares favorably to similar interventions in other countries and regions. For recovered children under five the average cost was reduced from US $ 52.3 to 22.9 and for recovered Pregnant and Lactating Women from US $ 41.7 to 16.2. Funding challenges created pipeline breaks affecting procurement and food deliveries which in turn reduced attendance levels in health facilities. The target beneficiaries for TSFP were 72,000 but by 2018 only 13,660 of the planned 48,100 beneficiaries for the year had been reached, though in 2019 the annual target of 24,050 was surpassed with 26,321 beneficiaries reached. Lack of resources also resulted in downscaling territorial coverage.

The lack of adequate, predictable and flexible funding resulted in the CO having to sacrifice medium- and longterm planning while frequently adjusting operations to available funds. Through 2019, the office experienced severe liquidity constraints and was only able to operate based on advances from Headquarters. The key partnerships were those with ministries. Effective partnerships depended on availability of funding and human resources capacity in Â鶹ÊÓƵ and the partner ministry. The CO lacked staff expertise and seniority to engage at the policy level and to build partnerships. The use of monitoring data for result based management was strong while Â鶹ÊÓƵ was directly engaged in the TSFP but limited in other areas such as capacity strengthening.