This document summarizes Nepal's efforts to adapt nutrition programs and implementation research during the COVID-19 pandemic. Key impacts of the pandemic included decreased access to health and nutrition services, increased risk of malnutrition, and food insecurity. Nepal adapted global guidelines for its context and leveraged mobile technology and its existing community health workforce to maintain basic nutrition services and disseminate COVID-19 information. A rapid assessment survey collected data on health practices, service access, food security, and COVID-19 impacts. Moving forward, the presentation recommends investing in local food systems, continuing nutrition services with a focus on equity, and empowering families through building resilience.

1. DELIVERING FOR NUTRITION IN SOUTH ASIA
Implementation Research in the Context of COVID-19
December 1, 2021
Pooja Pandey Rana
Chief of Party, Suaahara II Program
Helen Keller International Nepal
An example from Nepal
Adapting program actions and
implementation research to support
nutrition during COVID-19

2. Impacts
• Access and utilization of acute, curative
and preventive health and nutrition
services decreased
• 940,000 Nepalese children wasted prior to
COVID-19; 72,000 additional estimated to
be at risk
• Food insecurity increasing due to mobility
restrictions, income loss and rise in food
prices
• Vaccination impetus: 41 % received both
doses as of December 2021
COVID-19 and Nepal

4. Adapted global interim guidelines
for Nepali context
Infant and young child feeding, Integrated
management of acute malnutrition, Nutrition
information system, BMS monitoring protocol
Maintaining basic nutrition services
at community level
•Leveraging on existing Suaahara field presence,
including working with 28,000 female health
volunteers (FCHVs) to ensure delivery of nutrition
services, screening and referrals of acute
malnutrition cases
•PPE provision so that health workers/FCHVs can
provide services safely
•Shift to mobile counselling
Supporting the government's COVID-19 response

5. • Using multiple media platforms and
mobile technology to disseminate
information
• Setting up system to track
misinformation, rumors, and audience
information needs on COVID-19
allowing for continuously adaptation of
communication materials and strategies
• Establishment of community level
committees to facilitate contact tracing,
follow up on cases in home-based
care/isolation and promotion of COVID-
19 vaccine
Risk Communication for COVID-19

6. Tele counseling on
food production
system
5,000 households
Mobile and digital technology
Nutrition
commodity
tracking and
support
5,622 health
facilities
Personalized SMS
messages
1.74 million people
Referral to health
facilities and
humanitarian
programs
87,381 households
Diversified social
media
25.3 million views
Counseling on
maternal and child
nutrition
1.38 million families
Interpersonal
communication on
COVID-19 via tele-
counselling
2.8 million people
Suaahara II: Leverage on mobile and digital technology for
dissemination of COVID-19 information and for service provision
Ag input support to
HHs affected by
supply chain
disruptions: 35,882
households

7. Objectives: To assess health and
nutrition practices and service access
during the COVID-19 context in 389
municipalities across Nepal
Design: Cross-sectional survey;
Simple random sampling in 353
municipalities
Sampling: 23,471 Mothers (7 per wards);
772 Health facilities (2 per municipality)
and 3,353 FCHVs (1 per ward)
Data collection: Questions added to front
line worker (FLW) mobile job-aids
Suaahara II monitoring adaptations:
MIYCN Rapid Assessment

8. Type of data collected/tracked:
• Health and nutrition practices (e.g. ANC visits,
institutional deliveries, vitamin A)
• Food consumption and food security
• Health and nutrition services access, use and
barriers
• COVID-19 precautions at health facility
(handwashing, mask use, social distancing)
• COVID-19 information sources and reach
• Reduced income and psychological distress linked
with COVID-19
• Support received (e.g., cash, in-kind, protective
equipment, etc.)
Data use:
• FLW immediately referred vulnerable households to
health facilities, food distribution programs, etc.
• Weekly trends shared with program teams,
government, and development partners
• Visual presentation of data in maps/online
dashboards for further use by local governments
MIYCN Rapid Assessment

9. Looking ahead: Investing in local food and health systems
Refine targeting and linkages
• Intensify efforts to identify and reach
marginalized households
• Link households to livelihood and
social protection programs
Continue nutrition services
• Scale-up MIYCN/IMAM
interventions with focus on equity,
access, and quality
• Advocate for buffer stock of essential
nutrition commodities
• Expand use of technologies for
improving quality of services
Empower families, build resilience
• Early identification and treatment of
malnutrition
• Sustain homestead food production
• Expand targeted social and behaviour
change activities

10. • Invest in mobile technologies including
electronic based data systems to provide
timely data for program adaptation and to
support service provision
• Respond more effectively to the epidemic by
using insights from existing and new
program data
• Link data and programming so that they
form a virtual cycle
• Listen to your clients by establishing two-
way feedback systems to respond to
changing audience needs
• Intensify targeting of marginalized families
• Invest in implementation research to
generate learnings on how to support
populations in need in future emergency
contexts
Key messages

11. This presentation is made possible by the generous support of the American people through the United States Agency for
International Development (USAID). The content of this plan is produced by Helen Keller International, Suaahara II Program and
do not necessarily reflect the views of USAID or the United States Government.
Thank You!