Review of Integrated Food Security Programme in Malawi

Summary of published review¹

Areview of an Integrated Food Security Programme (IFSP), implemented by GTZ² in Malawi from 1997 to 2004, has recently been published by Tufts University. The IFSP in Malawi was a complex, multi-sector activity that sought to improve food security and nutrition in one of the country’s most vulnerable, least-performing regions. The programme was implemented by GTZ (now GIZ)³ on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ) between 1996 and 2003 (with a 12-month extension supported by the European Union).

The IFSP’s end-line evaluation reported that the intervention had achieved its objectives. A subsequent review was undertaken to consider whether gains made in the past had been sustained and to draw lessons from this example that may contribute to new thinking on models of integrated, multisectoral programming. The review highlights that "food security approaches to nutrition require systemic, multidisciplinary and inter-sectoral approaches" (UN Standing Committee on Nutrition, 2009, p. 1). It goes on to argue that the empirical evidence remains limited of what actually works on the ground, where attempts are made to introduce packages of interventions that address multiple sectors at once.

This review was conducted over a period of five months (November 2010 through March 2011) and involved two field trips. The findings presented in the review rest on three kinds of information: documented evidence (project, consultant, and published reports), insights shared by various experts and stakeholders, and direct experiences of the reviewers from the village visits.

Villages were visited based on meeting one of four criteria:

• Early adopters versus later adopters (villages included from the outset of the IFSP in 1997 versus those included later).
• Villages that recorded positive nutrition gains over the course of the IFSP versus those that were less positive.
• Villages that served as ‘controls’ in Phalombe District (prior to that district’s separation from Mulanje).
• Villages with specific examples of ‘success stories’ versus ‘failures’.

The review authors emphasised the limits to attributing findings of the review in any statistically significant manner. The IFSP could not maintain ‘pure’ control groups due to administrative re-districting in the late 1990s that removed original control villages from Mulanje District. Furthermore, there were many other agents of change both across Mulanje and beyond. While the review does not ascribe causality to the IFSP versus any other influences, an attempt is made to draw inferences about the role of the intervention where expected outcomes were achieved (as documented in the end-line evaluation). This is achieved by careful post-hoc interviews with those directly involved (beneficiaries as well as implementers), an assessment of the plausible links between inputs and outcomes, and triangulation across multiple sources of data with Mulanje and neighbouring districts.

The intervention which started in 1997 encompassed 185 villages (roughly 40,000 households). Mulanje District was selected because it represented "an area which has chronically suffered the greatest food deficit over the last 10 years, compared to other areas in Malawi". An obvious manifestation of the severity of local problems showed up in the causes of paediatric mortality in Mulanje District Hospital, which in 1993 were reported as malnutrition (21% of cases), malaria (19%), and anaemia (11%). In 1997, malnutrition and anaemia were still among the top three causes of death locally (at 18% and 14%, respectively), with HIV/AIDS having taken over first place.

The initial roll-out villages were chosen largely because at that time they had "no interventions by other donor agencies", in other words, they were seen as "pristine" and more likely to demonstrate changes more clearly in the absence of other donor activities.

Key findings of the review

The IFSP in Mulanje was successful in most of its aims. Not only were conclusions of the 2004 Final Evaluation Report confirmed, but many of the gains identified then have been sustained. This represents an important "proof of concept" of this particular approach to integrated programming. Successes can be identified as helping bring positives changes in food security (measured by outcomes across multiple sectors), changed thinking and behaviours at community level (that persist a decade later where ‘early adopters’ have continued to innovate), and new approaches to tackling food insecurity that have been adopted by the public sector locally and nationally. The IFSP has influenced government thinking on food and nutrition security more broadly, leading to many of its principles being embedded in current national policies.

In terms of specific successes, child nutrition was improved (reaching the target set of a 10% reduction in the prevalence of stunting) and most sectoral targets were also achieved. Gains that can be attributed by varying degrees to the IFSP include enhanced agricultural productivity and output in several staple crops, the cultivation of an enhanced range of crops (as a result of introduction and promotion of new and improved seeds), and reduced losses to crop and livestock diseases - all leading to higher levels of farm output. This in turn contributed to reduced periods when farm households have no food in their stores, higher household incomes, and increased local investments in productive assets, including in the natural resource base.

Beyond agriculture, the IFSP promoted non-farm income diversification activities that have since proliferated, allowing for more diversified livelihoods and disposable income. Access to market (for sale of crops, purchase of food, and engagement in cottage industries) was improved through access road and bridge construction, still well maintained in most instances. The supply of clean water has improved significantly, and maintenance of water points has been good, largely supported through village committees. Access to food for-work represented an important safety net for food-insecure households who could not immediately benefit from enhanced farm productivity and market access. Improved supply of food and income has supported enhanced diet diversity and quality. A wider range of foods is consumed today than prior to the IFSP, and also compared with most other parts of the country. Food preservation activities have enhanced diet choices and reduced post-harvest losses.

The process of community engagement was valuable and valued. Community and government training in problem-solving processes are still in use today. Many village committees are still functional, and the promotion of ‘demand responsive’ models of service delivery had durable impact on the way that public servants conduct their business. The IFSP model was widely promoted in Malawi and its lessons have been incorporated into training and policy agendas since the end of the intervention.

Conclusions of the review

A number of broad conclusions emerge. The IFSP represents a model of integrated programming, carefully designed around a core conceptual framework, which achieved its targets. But it is not the only possible model, either for achieving such targets or for approaching integrated programming as a process. The Mulanje example should be carefully analysed against other potentially viable approaches in seeking to understand how best to leverage actions across multiple sectors to achieve gains in agriculture, nutrition, and health simultaneously.

The IFSP model appears to have been relatively cost-effective. At roughly US$59 (around €40) per household, or US$11 person (€8) per year, the package of IFSP interventions compares well with a range of other integrated programmes in Malawi and elsewhere. That said, not every element of the package worked equally well, with home gardens, some health interventions, and some crops performing weakly compared with other components of the programming.

The successful (versus weak) aspects of this activity shone a spotlight on the importance of cultivating leadership for change. Engagement of community leaders as stakeholders and the intensive training of villagers in leadership roles and committee processes was critical. So too was establishing appropriate incentives and buy-in across district- and national-level ministries so that ‘ownership of leadership’ was cultivated and service delivery and programme implementation all benefitted. Identification and support for early adopters (leaders in innovation) mattered immensely to ‘start-up’ activities in the realm of livelihood diversification. Attention to this process aspect of programming was critical.

Questions raised by the review that should frame debate on future integrated programming include:

1. Could the same outcomes have been achieved for less cost?
2. If so, what is the minimum versus desirable menu of interventions that would (together) generate the best possible outcomes for least cost?
3. Would the unit cost of the package introduced in Mulanje rise or fall if taken up at scale across the country?
4. Should such packaged interventions seek to promote absolute change or accelerate relative change (to bring ‘lagging’ regions or communities up to par with the rest of their country)?
5. Can integrated programmes be designed to buffer future shocks, not just resolve pre-existing vulnerability to food insecurity, and what would that add to the cost of a package of integrated services and inputs?

Many such questions can only be answered through operations research on a next generation of multi-sectoral integrated programme, which this review concludes is a reasonable development policy priority.

¹Webb. P (2011). Achieving Food and Nutrition Security: Lessons Learned from the Integrated Food Security Programme (IFSP), Mulanje, Malawi. June 2011. Download at: http://www.donorplatform.org/load/11188

²German Technical Cooperation. This is now part of GIZ since 1 January 2011 (see footnote 3).

³Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH. The German Society for International Cooperation (GIC) Ltd is a federal enterprise that supporst the German Government in achieving its objectives in the field of international cooperation for sustainable development.