Operational research and impact evaluation (ORIE)

Over a million children under five die every year in Nigeria and over 50% of these preventable deaths are attributable to undernutrition. We are leading a consortium of specialist partners adopting a mixed-methods approach to assess the effectiveness of DFID’s ‘Working to Improve Nutrition in Northern Nigeria’ (WINNN) programme. The team is implementing a quasi-experimental impact evaluation incorporating household-surveys and qualitative research to assess performance over the programme’s lifetime. Operational research will be conducted alongside this evaluation to help identify the most optimal implementation strategies for different WINNN interventions as they are rolled-out. These approaches will be complemented by cost-effectiveness analysis and a cohort study to investigate the determinants of stunting and address crucial evidence gaps in the underlying causes of undernutrition in the region. In addition, the team will develop a comprehensive dissemination strategy as well as unique opportunities for capacity building in the nutrition sector in Northern Nigeria to help maximise the policy-value of project findings.

Challenges

Over a million children under five die every year in Nigeria. A large proportion of these preventable deaths are due to undernutrition and the number of stunted children remains higher in Nigeria than in any other sub-Saharan African country. The situation is especially bad in the North of the country where more than a third of children are underweight and one in five suffer from acute malnutrition.

DFID is rolling out an ambitious six year programme to address these issues by improving maternal, newborn and child nutrition across five states in Northern Nigeria. The ‘Working to Improve Nutrition in Northern Nigeria’ (WINNN) programme incorporates a number of direct healthcare interventions focusing on the treatment and prevention of malnutrition. These include community-based management of acute malnutrition (CMAM), vitamin A supplementation and infant and young child (IYCF) interventions.

This project was established to support the roll-out of WINNN by independently assessing its performance and gathering evidence that will feed into the improvement of programme interventions, maximising their impact as they are being implemented.

Our approach

We are leading a consortium of partners contributing to the strengthening of DFID’s WINNN programme through a range of approaches.

The team will conduct a quasi-experimental impact evaluation based around assessing the ‘difference-in-differences’ between treatment and control groups. Data from household surveys will be complemented by findings from detailed qualitative research activities including focus group discussions and key informant interviews. Operational research will also be conducted alongside this overarching evaluation to help refine WINNN interventions as they are being rolled-out. This will involve making necessary programme updates based on cost-effectiveness and efficiency evidence from in-field assessments of different delivery platforms.

In addition, the team will undertake pilot studies to delve deeper into the underlying causes of undernutrition and establish an evidence base to support the development of strategies to tackle longer-term, structural barriers.

Ensuring the sustainability of interventions is a key focus of the project and the team is developing strategies to effectively disseminate findings and ensure their uptake by a range of stakeholders including government officials, academics, NGOs and civil society organisations.

Specific activities include:

• completing a systematic review of evidence to identify successful nutrition interventions and their applicability to the Nigerian context;
• designing and implementing a quasi-experimental impact evaluation incorporating household surveys, key informant interviews and focus group discussions;
• conducting mixed-methods operational research into different programme interventions and making strategic recommendations;
• completing cost-effectiveness analyses;
• undertaking a cohort study to understand the determinants of stunting in Northern Nigeria through a longitudinal study; and
• developing innovative dissemination strategies and capacity building programmes based on stakeholder mapping.

Gender mainstreaming will be an overarching theme of the project from collecting and analysing gender disaggregated data to ensuring the prominence of the views of excluded groups. Our specialist gender team will advise at all stages of design and implementation to help ensure the equity of project outcomes in line with wider development goals.

Outcomes

The project will provide robust evidence and support Federal and State-level governments, DFID and implementing agencies (UNICEF, Save the Children and ACF) to better understand the implementation and impact of nutrition interventions in Northern Nigeria. It will help ensure that the WINNN programme both draws on, and feeds into, cutting-edge knowledge on strategies to overcome undernutrition.

By adopting an operational research approach, the team will directly contribute to the refinement and implementation of the programme programme, helping to leverage successful interventions and maximise their wider impact.

Over the longer-term, by providing an assessment of the WINNN programme performance over its lifetime, this project will help support the design of improved nutrition sensitive and nutrition specific interventions, the scale-up of existing nutrition programmes and more targeted policy making.