Somalia Multisectoral Nutrition strategy (SMNS) - Humanitarian Response

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Somalia Multisectoral Nutrition strategy (SMNS) - Humanitarian Response
Somalia Multisectoral Nutrition
       strategy (SMNS)
Goal

To reduce malnutrition through direct Maternal and Child Health
Nutrition (MCHN) interventions and indirectly through nutrition-
sensitive interventions that reduce poverty and food insecurity.
Expected Impact

• Contribute to improved nutrition outcomes especially in the first 1,000 days
  of life and in early childhood up to 5 years of age.
• Decrease the proportion of under five children who are stunted from 12
  percent to 7 percent.
• Decrease wasting to below 15 % WHO emergency levels;
• More than half of the under-five will be consuming the minimum
  acceptable diet.
Objectives:
Somalia Multisectoral Nutrition Strategy
               (SMNS)
SMNS Objectives.
• To create an enabling policy and legal environment necessary for
  improvement of nutrition outcomes across all the sectors both at national
  and sub national level
• To create, strengthen and sustain sectoral and Multi-Sectoral Nutrition
  coordination mechanisms at national and sub-national levels.
• To improve and strengthen human resource capacity for providing
  appropriate support to maternal and child nutrition at national and sub-
  national levels.
• To develop and integrate a full package of nutrition-specific interventions
  into basic health care services at national and sub-national levels
SMNS Objectives.
• To improve policy and practises that enhance maternal and child nutritional
  status through optimal use of nutrition-sensitive services.
• To address gender and social-cultural factors that hinder improvement of
  maternal, infant, and young child nutrition at national and sub national level.
• To strengthen organisational, institutional and policy framework for linking
  humanitarian relief, to recovery and development towards to nutrition
  improvement at national and sub national level.
Context and process
What is costing useful for?

• Assessing efficiency in two “equivalent” programs

• Identifying important cost issues for potential savings.

• Strategic planning and budgeting for programmes

• Together, costing and budgeting helps the planning process by ensuring that the
  goals are financially affordable.

• Benchmarking and Cost recovery
Why operationalise it?
• SMSN a tool multi-sectoral cooperation and coordination's for
  improved nutrition outcomes in Somalia
• Essential to estimate the total resource requirement for
  implementation
   • Guide contextualized implementation planning
   • See whole of nutrition programming at a glance
   • Compliment Monitoring & Evaluation and accountability framework
   • Facilitate domestic resources mobilisation
   • Identify gap and guide future investment
Costing Objectives
1. Facilitate costing of the intervention areas identified within SMSN
2. Develop a simple financial tracking and resource mobilization framework
    for the SMSN-Resource Availability & Gaps
3. Develop prioritized investment scenarios [simulations] to provide funding
    or priority choices-funding uncertainities:
    a) Funding above the current financing level: High funding performance scenario
    b) Current funding basket; if the status quo remains: Current funding scenario
    c) Funding below current financing level: Least performance scenario
Methodology
• Three approaches                          1. Analytical Approach: Input-data
   • Analytical approaches: Modelling of       modelling [ABC Approach]
     cause-and-effect relations                • Use of bottom-up approach ;an input-
   • Participatory approaches: Involving         based
     stakeholders                              • Costing of all inputs required to achieve
   • Knowledge management: collection and        Strategic plan targets
     processing of data
Methodology Cont…
2. Stakeholder Engagement                        • Source: Government and non-
   • Inclusive & participatory approaches          government actors
       • Government, UN agencies, CSOs           4. Data Analysis & Modelling
       • Desk reviews from published documents
                                                    • Budget allocations and projections trends
• Methods: KIIs, workshops, resource                  and patterns/analysis
  tracking & review of secondary data
                                                 5. Dissemination
3. Resource Tracking & Input Costing
   • Estimating resources available based on
                                                    • Inclusive review and feedback
      budget and budgets projections                • Adoption as an advocacy tool
Costing perspective
• Patient perspective
   • The patient only or the patient and care-giver
   • Also known as patient or consumer costs
• Health system (Provider) perspective
   • The health system only
   • Easy to get data
   • Also known as provider costs or health system costs.
• Societal perspective
   • Costs to the society
   • The patient, health system and any other relevant individuals/entities
   • Broad; puts all costs together from different aspects of society that would benefit
Cost concepts

• Incremental costs
  Additional costs arising from change in decision

• Micro based costing
    Bottom up approach based on the theory of change.
ABC Steps in summary

•   Identify activities
•   Determine inputs for each activity
•   Determine cost for each inputs
•   Determine cost drivers
•   Collect activity data
•   Calculate product cost
Challenges
• Resource tracking and Mobilization among
  partners, donors and other multi-sectoral actors
• Alignment and identification of proposed
  activities under each of the objectives
• Implication???
Questions
Preliminary Costing Results
Cost by Strategic objectives
                                   Strategic objective                                  2019/20 2020/21 2021/22 2022/23 2023/24 Total
SO.1: To create an enabling policy and legal environment necessary for improvement of
nutrition outcomes across all sectors at national and sub national level.                   0.08    0.76    0.26    0.41    0.32 1.83
SO. 2: To create, strengthen and sustain sectoral and Multi-Sectoral Nutrition
coordination mechanisms at national and sub-national levels                                 0.63    0.57    0.59    0.63    0.25 2.67
SO. 3: To improve and strengthen human resource capacity for providing appropriate
support to maternal and child nutrition at national and sub-national levels.                0.08    1.10    0.74    0.52    0.19 2.64
SO. 4: To develop and integrate a full package of nutrition-specific interventions into
basic health care services at national and sub-national levels.                             0.68    3.32    2.62    2.65    1.50 10.77
SO. 5: To improve policy and practices that enhance maternal and child nutritional
status through optimal use of nutrition-sensitive services.                                28.97 73.02     60.43   30.65   24.67 217.75
SO. 6: To address gender and social-cultural factors that hinder improvement of
maternal, infant, and young child nutrition at national and sub national level.             3.10    3.52    3.54    3.20    3.10 16.46
SO. 7 : To strengthen organisational, institutional and policy framework for linking
humanitarian relief, to recovery and development towards to nutrition improvement at
national and sub national level.                                                            9.01 11.30     11.29    8.99    9.10 49.70

Total per year                                                                        42.55    93.59   79.48    47.05     39.13 301.80
Weight of the cost by SO.
Strategic objective 7                         17%

Strategic objective 6             5%

Strategic objective 5
                                                                                  73%

Strategic objective 4         4%

Strategic objective 3        1%

Strategic objective 2         1%

Strategic objective 1        0%
                        0%        10%   20%         30%   40%   50%   60%   70%     80%
Cost by year of implementation
                      2023/24, 13%   2019/20, 14%

     2022/23, 16%

                                                    2020/21, 31%

                2021/22, 26%
Challenges
• Resource tracking and Mobilization among partners, donors
  and other multi-sectoral actors
• Alignment and identification of proposed activities under each
  of the objectives.
• Lack of whole scope of identified nutrition
  interventions/activities under humanitarian and development
  response.
• Implication???
Questions
THANK YOU
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