Evidence-Informed Scale Up of NICHE in Kenya By Jane Muyanga

1. TRANSFER PROJECT WORKSHOP
Venue: Ole Sereni Hotel- Nairobi
Dates: 21st – 23rd June, 2023

2. Evidence-informed scale up of NICHE in Kenya:
Focus on the in-depth experience of currently
scaling up a cash plus nutrition pilot of the Cash
Transfer for Orphans & Vulnerable Children (CT-
OVC)
Jane Muyanga - Kitili
National Social Protection Secretariat - Kenya

3. Outline
 Background on CT program
 The genesis of NICHE
 Aim & Objective of NICHE
 Components
 Coverage
 Implementation arrangements
 Lessons
 Going forward

4. The CT program
o Started as a pilot program in 2004
o Started in 3 districts (currently sub-counties)
with a total of 500 beneficiary HHs
o Has expanded to include older persons and
persons with severe disabilities
o Currently CT has 1.2m persons and
Households
o Payments were done initially done
manually- done through banks- transfer
value $20

5. The CT complementary program
o Complementary programmes include
education support - bursary
o Economic inclusion
o Nutrition improvement through cash and
Health Education(NICHE)

6. Origins of NICHE
o Is a ‘Cash Plus’ intervention that combines a
regular cash stipend together with
nutritional counselling to expectant and
lactating mothers
o Started as a pilot in Kitui County in 2017 in
collaboration with Kitui county government
to address issues of malnutrition, stunting
and wasting amongst infants and children

7. Aim & Ojective
o Aims to improve the nutrition of pregnant
and lactating mothers and of children under
2 years, and protect them from violence and
abuse
o The main objective is to improve nutritional
& developmental outcomes for children
especially in the first 1,000 days that define
human development

8. 8
Study Design
CT-OVC
beneficiaries
Treatment arm
- Additional cash
- Nutritional
counseling
Control
group
RCT with aim aggregated
sample size of 1,306 for each of
the two arms
Key Variables:
- Stunting, wasting and underweight
- Secondary outcomes
FGDs and IDIs to gain additional
information on relevance,
effectiveness and efficiency

9. Results of the pilot
o Positive results at secondary outcomes level
(health, nutrition, WASH)
o Treatment households more likely to
practice enhanced hygienic, dietary and
infant care practices than comparison
households
o A trend towards stunting reduction was
recorded in the beneficiary group

10. Results contd’
o Value and relevance of CHVs in fostering
behavior change at HH level recorded
o Combining cash transfer and counselling
improves wellbeing and positive behavior
change
o These results are what prompted the scale-up
under the Kenya Social Economic Inclusion
Project - KSEIP

11. Child malnutrition situation
oPoor human capital development
oHigh levels of malnutrition
amongst under 5
oPoor dietary diversity
oPoor feeding and nutritional
practices by parents and caregivers

12. NICHE Target
o Target pregnant woman and child under the
age of 24 months household already in
receipt of an National Safety Net Program
cash transfers (CT-OVC, PWSD-CT, OPCT
& HSNP)

13. Components of NICHE
 Cash top ups (500 Kshs per child/ pregnant
woman/ month capped at two children
under 2yrs
 Intensive weekly nutrition counselling
 Positive Parenting counselling to improve
care practices and prevent violence
 Payments are bi-monthly through banks
together with the cash transfer payments

14. NICHE key action points

15. Implementation
Arrangements – Community
 NICHE Leverages Community Mechanism
structures to provide Nutrition (Baby
Friendly community Initiatives), Cash
Transfer and Child Protection Interventions
( CHVs, BWCs, LVCs and CPVs)
 CHVs offer nutrition counselling while CPV
offer positive parenting sessions to the
NICHE beneficiaries through household
visits at least twice per month.

16. Status Contd’
 More than 500 health workers /Community
Health Extension workers trained
 About 6,000 CHVs have been trained on the
Baby Friendly Community Initiative and are
actively providing counseling to HHs
 About 3,700 mother-to-mother support
groups were formed, reaching over 45,000
women with nutrition information.

17. Status Contd’
 In Kilifi, Positive Parenting Component was
successfully piloted:
• 56 Child Protection Volunteers & 23 Lay
Volunteer Counsellors trained to become positive
parenting group facilitators
• 1,550 CHVs trained on positive parenting and
care reforms
• 1,713 NICHE beneficiaries reached with sessions
on positive parenting and family-based care
• 750 NICHE parents/caregivers graduated from
positive parenting following National Positive
Parenting Manual

18. Benefits of
NICHE
o Improved child developmental outcomes –
Education, Nutrition & Health
o Reduction of inequality & exclusion
o Economic stimulus & inclusive growth & devpt.
o Human Capital Development
o Fulfils every child’s right to SP
o Demographic development

19. Lessons Learnt
o Strategies to address poverty, undernutrition
and child protection can be integrated
o Cash plus counselling can support uptake of
nutrition practices and improve access to food.
o Positive parenting counselling can promote
responsive care and reduce violent discipline
o Multi-sectoral coordination structures can help
facilitate coordination between sectors

20. Lessons Learnt
o Aligning integrated programs with sector
strategies generates political will for joint
programs
o System linkages are needed at program level
to enable joint targeting and management
o Programs should be designed to be capable of
responding to emergencies, e.g. shocks

21. Going forward
 Increase advocacy with Treasury to prioritize
investments in the social sectors especially in
nutrition, child protection and social protection to
ensure that Kenya conforms to the Convention on
the rights of the child
 Prioritize national & county government level policies
such as the Social Assistance Fund, the social
assistance bills to ensure resources are ring-fenced to
address social protection and malnutrition
 Work along the MoU commitments to unlocking the
county-national funding flow bottlenecks especially
on funds ring-fenced to respond to malnutrition

22. Going forward contd’
 Strengthen inter-ministerial communication
as well as national and county governments
coordination mechanisms to streamline
programme implementation
 Continue leveraging on technology to
simplify bureaucratic processes that are
resource intensive such as registration
systems but also support data utilization for
policy making at county levels

24. THANK YOU