Photo © Martin Aspin
External Mid-Term Evaluation
‘Support for the socio-economic development of
the communities within the Spanish Development
Cooperation’s action zones in the Philippines Program’
Funded by AECID
Martin Aspin and Ella Jordan, Oct 2012
This report is commissioned by Action Against Hunger | ACF International. The comments contained herein
reflect the opinions of the Evaluator only.
TABLE OF CONTENTS
LIST OF TABLES
2
LIST OF ACRONYMS AND ABBREVIATIONS
3
ACKNOWLEDGEMENT
4
EXECUTIVE SUMMARY
5
1.0 BRIEF BACKGROUND
8
2.0 METHODOLOGY
10
3.0 FINDINGS AND DISCUSSION
12
3.1 Quality of Program design
3.2 Sustainability
3.3 Relevance/Pertinence
3.4 Coherence
3.5 Effectiveness
3.6 Efficiency
3.7 Involvement/Participation
3.8 Control
3.9 Integrated focus
3.10 Cross Cutting Issues
12
16
19
22
24
33
35
37
38
40
4.0 CONCLUSIONS AND RECOMMENDATIONS
41
5.0 DAC GUIDELINES
46
6.0 GOOD PRACTICE IDENTIFIED FROM THE EVALUATION
47
ANNEXES
Annex 1 – Key Informants and Documents reviewed
Annex 2 – Sample of Most Significant Stories
49
52
LIST OF TABLES
Table 1: Number SAM Cases Detected and Treated…………. ................................ 24
Table 3. Beneficiaries of 1st batch of Agriculture and IGA inputs............................. 27
Table 4. Status of Farm Plan and Business plans ................................................... 28
Table 5. Water Systems and Tap Stands Completion and Coverage ...................... 30
LIST OF FIGURES AND PHOTOS
Photo 1: Functioning OTPs in Lanao Del Sur Province ........................................... 26
Photo 2: Farmer Help Groups ................................................................................. 29
Photo 3: Water planning .......................................................................................... 31
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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List of Acronyms and Abbreviations
ACF
AECID
BAWASA
BDP
BNS
BHW
CTF
DoA
DoH
ENA
FGD
FSL
GAM
GOP
IGA
KAP
MAM
IMAM
IMCI
ITP
IYCF
LGU
MAO
M&E
MoU
NGO
OTP
PIMAM
PMU
RHU
RUTF
SAM
UNICEF
USD
WASH
WFP
Action Contre la Faim (Action Against Hunger)
Spanish Agency for International Development Cooperation
Barangay (village) Water and Sanitation Association
Barangay Development Plans
Barangay Nutrition Scholar (Nutrition worker)
Barangay Health Worker
Coordinating Task Force (Provincial PMU)
Department of Agriculture
Department of Health
Essential Nutrition Action
Focus Group Discussion
Food Security and Livelihoods
Global Acute Malnutrition
Government of The Philippines
Income Generating Activity
Knowledge, Attitude and Practice
Moderate Acute Malnutrition
Integrated Management of Acute Malnutrition
Integrated Management of Childhood Illnesses
In-Patient Therapeutic Program
Infant and Young Child Feeding
Local Government Unit
Municipal Agriculturist Officer
Monitoring and Evaluation
Memorandum of Understanding
Non-Government Organisation
Out-Patient Therapeutic Program
Philippines Integrated Management of Acute Malnutrition
Program Management Unit
Rural Health Unit
Ready to Use Therapeutic Food
Severe Acute Malnutrition
United Nations Children’s Fund
United States of America Dollars
Water, Sanitation and Hygiene
World Food Program
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Acknowledgement
Thank you to ACF Philippines for sharing their experiences and providing
introductions to staff, partners and beneficiaries. It was great to meet those
contributing to improving the socio-economic conditions of remote communities
across Mindanao in the Philippines.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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EXECUTIVE SUMMARY
Action Contre la Faim’s (ACF) four-year ‘Support for the socio-economic
development of the communities within the Spanish Development
Cooperation’s action zones in the Philippines’ Program, has contributed to
reducing child malnutrition, provided improvements in household food security, and
delivered greater access to water and sanitation facilities (WASH) to remote
communities across Central Mindanao. The program has also established the
foundations for stronger local governance and community engagement in the
planning and delivery of social services across targeted municipalities in North
Cotabato and Lanao Del Sur.
Established in March 2010 and funded by AECID, the program is scheduled to be
completed in July 2014 at a cost of approximately 3.2 million Euro with an additional
800,000 Euro co-contribution in kind or cash from partners, local governments and
the communities. This mid-term evaluation examines the first two years of the
program and provides recommendations for the remaining two years.
The main focus of the evaluation was to examine the implementation strategies and
approaches, and how key program activities are achieving the overall goal of
contributing to poverty reduction in rural and peri-urban communities. The evaluation
was conducted through a mix of focus group discussions (FGDs), learning
workshops, semi-structured interviews, program document review and site visits
across the provinces of North Cotabato and Lanao Del Sur in Mindanao, Southern
Philippines.
The program represents a new approach for ACF Philippines. It is the first time
Good Governance has been incorporated as a cross-cutting issue into ACF’s
traditional mix of Food Security, WASH and Livelihoods initiatives. For ACF
Philippines, it is also the first time nutrition has been added for a more integrated
approach to programming. This approach was encouraged by the donor AECID and
which has already seen the establishment of several community and government
groups with representation from key sectors including agriculture, health and water
users.
Moving forward, the program will need to ensure a more pro-active dialogue
between ACF and its partners, local government and the community when it comes
to planning, design and monitoring of activities. Newly formed governance and
community groups were observed as only receiving program information from ACF
and missed the opportunity to be fully engaged in the process. Good Governance as
a cross-cutting issue is often time consuming and complex, which should be included
in future planning. Activities should be initiated by ACF and co-led by local
authorities in a complementary approach with ACF and its partners. This is not
always easy bringing community and government together, however it should be an
integral part of the learning process for developing good governance, transparency
and community ownership.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Overall, the community felt engaged with the program, highlighted by active water
user and health care/nutrition groups; both leading activities such as the
maintenance of new water infrastructure and detection and treatment of
malnourished children. However, there still remains a level of community apathy and
risk of dependence on outside assistance. ACF and its local partners Don Bosco and
Maradeca should continue to advocate for community engagement, specifically to
ensure that people pressure their leaders to be accountable and provide
transparency in the planning and allocation of resources.
Examining Nutrition and Care Practices, the evaluation found ACF has made
significant progress in reducing child malnutrition with a significant drop in the
number of screened severely acute malnourished (SAM) children in the program
areas. Significant progress has also been made on the improvement and servicing of
Out-Patient Therapeutic Program (OTP) and local health clinics. Local volunteers
and paid health staff have been trained and were provided with equipment in
partnership with UNICEF, German Doctors and Montaner hospital to effectively
detect, treat and prevent child malnutrition. Moving forward, more education and
advocacy in the community would help mothers better understand the link between
good nutrition, sanitation, food security and a healthy child.
Examining food security and livelihoods, the evaluation found that ACF’s program
had faced several challenges including agricultural inputs, cropping delays and poor
weather, however had made positive steps to increase household knowledge and
ability to provide diversified food for the family. Further work in the coming years
needs to focus on small household gardening, improved use of locally sourced nonhybrid seeds and production of organic fertiliser and natural pesticides.
There are some opportunities to expand ACF’s farming initiatives to include
seedling nurseries and demonstration plots. Both should be led and maintained
by local farmers who would pass on practical skills to other farmers through formal
and informal training. This would also make use of existing traditional indigenous
farming methods, which are a valuable source of knowledge and experience.
The provision of water sources to remote communities has had a positive impact on
household’s day-to-day living and provided a key source of water for household
daily use, home-gardens and farming. Before ACF’s water initiatives, households
were forced to limit their water use or walk several kilometres and spend significant
portion of the day bringing water for basic household needs and farming. Now, over
2000 households have improved water access.
Regionally, there are differences between the two provinces of North Cotabato and
Lanao Del Sur. North Cotabato experienced greater progress and was more effective
at gaining the trust and openness of the people and local authorities. Long standing
cultural and religious differences between communities and more regional conflicts
could explain the slower progress of Lanao Del Sur, as may the positive environment
and acceptance of good governance in the municipality of Arakan in North Cotabato.
Program design was overall sound and is characterised by establishing community
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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and local government structures and partnering with NGOs such as Don Bosco,
German Doctors and Maradeca. Both these design features assisted in the
socialisation process and identification of vulnerable households across previously
unassisted remote areas of Mindanao.
In working with local authorities, ACF needs to continue to engage and be aware of
government protocols, procedures and constraints regarding planning and budgeting
of social services and infrastructure. Local and provincial governments were
aware of poor basic services, but are constrained by poorly designed
development plans, long lead times for processing infrastructure plans, limited tax
revenue generated in remote areas and limited allocated budgets for their region.
Moving forward, ACF need to identify these gaps when applying their programs and
incorporating cross-cutting good governance initiatives. This will facilitate an
approach that resolves issues with the entire community and encourages better
delivery of local government plans.
Overall, ACF has developed a solid model for integrating nutrition, food security,
water and sanitation, and good governance. There is however, greater need to
implement key services in partnership with local authorities, whilst ensuring
transparency, to access the full potential of reducing poverty across Mindanao.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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1.0 Brief Background
1.1 Introduction
ACF has been working in The Philippines since 2000 in both emergency and
development settings. This new program ‘Support for the Socio-economic
Development of the Communities within Spanish Development Cooperation’s
Action Zones in the Philippines’ or simply called ‘The Convenio Program’ was
developed to contribute to poverty reduction in vulnerable communities across
Mindanao which has long been affected by conflict and limited access to basic
services.
Funded by The Spanish Agency for International Development Cooperation (AECID),
the program set out to introduce a new approach to programming for ACF. Key to this
new approach was integrating core ACF activities such as Nutrition, Food Security
and Livelihoods and WASH together with the cross-cutting issue of Good
Governance. The aim of the program is to provide basic services while developing
the capacity of local institutions to deliver more effective service, whilst also
encouraging community leadership in the development of local planning and
ownership of activities and services.
1.2 Objectives of program1
1. To improve socio-economic conditions by facilitating access to services and
means of food security, water and nutrition at household and community level
through reinforcement of civil society.
2. To improve the delivery of basic services at local and national level through
awareness and capacity building in good governance and advocacy in child
malnutrition.
1.3 Target Areas
The program covers several municipalities across Mindanao deemed to be the most
vulnerable, remote and high risk of child malnutrition. They include: Kapatagan in
Lanaodel Sur, with barangays (villages) Proper Kapatagan, Bongabong and Daguan;
Arakan in North Cotabato with barangays Ganatan, Kinawayan, Maria Caridad and
Tumanding; and President Roxas also in North Cotabato with barangays Bato-bato,
Datu Inda, Datu Sundungan and Lama-lama. The map below illustrates the key
project area across Mindanao visited by the evaluation.
1
Adapted from the Program Proposal 2010
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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The evaluation was able to access Kapatagan in Lanao del Sur, Arakan and
President Roxas both in North Cotabato, and Cotabato City for visits to beneficiaries,
partners and local institutions. A trip to Manila enabled visits to the Department of
Health, UNICEF, AECID and ACF Capital Coordination Office management and staff.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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2.0 Methodology
2.1 Evaluation Goals2
The evaluation will review the implementation strategy and progress up until July
2012. The analysis and findings contained in the evaluation is based on a review of
the program documents and supported by concrete data and information, including
site visits and interviews with a representative sample of collaborators and
beneficiaries. The evaluation will make recommendations and lessons learnt for each
sector and the program’s overall strategy.
The evaluation will consider the program’s new integrated approach and its effects on
achieving program goals. The evaluation should offer recommendations for
measuring and demonstrating the impact on beneficiaries of this approach. The
analysis should focus not only on the impact of the planned activities but also on the
processes, strategies and methodologies followed, based on the criteria defined in
the evaluation framework.
The evaluation will provide an overview of the program’s main technical focuses:
Nutrition, Food Security and Livelihoods, Water and Sanitation, and Good
Governance.
2.2 Evaluation Criteria
The evaluation will examine the following key criteria utilising DAC3guidelines.










Quality of program design
Sustainability
Relevance/Pertinence
Coherence
Efficiency
Effectiveness
Involvement/Participation
Control
Integrated focus
Cross-cutting elements and issues
2.3 Evaluation Tools
The evaluation was conducted using a mixed qualitative method, utilising existing
program documentation, focus group discussions, key informant interviews and site
visits. These provided a thorough examination of program activities within the limited
timeframe. The evaluation combined two consultants who examined contrasting
regions of the program. Both consultants examined food security, water and
sanitation, nutrition and good governance activities at local, municipal and provincial
2
3
Extracted from the Evaluation Terms of Reference
OECD Development Assistance Committee developed guideline standards.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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levels using best practice participatory methods including group simulations, most
significant stories and the ‘river of life’ mapping to assist the learning process.
Interviews were conducted with ACF staff, local partners, community leaders and
beneficiaries to obtain a comprehensive review of program activities. A full list of key
informants interviews and documents reviewed is listed in annex 1.
Semi-structured interviews were guided by targeted questions. Questions examined
the outcomes and on-going strategy of the program in addition to program activities.
Additional site visits across Mindanao provided the consultants an opportunity to
inspect programs and meet communities.
Following the fieldwork in Mindanao, learning workshops were conducted in North
Cotabato and Lanao Del Sur for a mix of stakeholders at different levels, including
community members and field staff to share in a series of learning and simulation
planning activities. A report will be prepared and shared in early October 2012.
Feedback and comments from ACF Headquarter Coordination staff will then be
incorporated into the final evaluation report.
Time constraints in the field resulted in the two consultants examining two different
areas for the fieldwork. One consultant examined North Cotabato and the other
visited Cotabato City and Lanao Del Sur, both for a period of one week only. Security
issues restricted the time in the field meeting stakeholders, as the consultants had to
return to a remote base daily. The consultants shared their findings and discussions
from FGDs and key interviews. Both consultants met with Manila ACF staff, as well
as Ministry of Health and UNICEF representatives.
Lack of progress and success in agriculture activities and timing of cropping season
resulted in very few examples of food security programs being examined by the
consultants. The consultants were able to meet with farmers and representatives
across government and partners to discuss FSL strategies and activities, however
analysis of actual results was limited.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.0
FINDINGS AND DISCUSSION
3.1 Quality of Program design
The evaluation found that program design consulted with community and government
institutions, examined past ACF and partner experience, analysed risk and made
preparatory assessments before establishing this new integrated approach to
programming.
Program goals and objectives provided a clear framework to deliver an integrated
mix of traditional ACF initiatives including Nutrition, FSL, WASH and Good
Governance. Stakeholder analysis reveals overall support from ACF partners has
been sound and ready and able to continue over the next two years.
3.1.1 Stakeholder Analysis
The following table summarises stakeholder involvement in the program. It identifies
strengthens, weaknesses and opportunities for the next 24 months of the program.
Stakeholders
ACF
Strengths
Weaknesses
Core values FSL and
WASH.
New using Nutrition +
good governance
Experience working
with vulnerable
communities across
Mindanao
New integrated
approach for ACF
Philippines
AECID Madrid
Donor Funding and
past experiences
Distance and timeliness
of approval/requests.
Maradeca
Community
development and local
experience
Strength working
remote and vulnerable
communities
Adapting to new
approach
Don Bosco
German
Doctors/Montaner
Hospital
Food security
experience
Health and Nutrition
focus
Effective management
of ITP
Small team with large
workload
Little leverage over ACF
to make changes
Limited resources
Links to Hospital
UNICEF
Supplier of good (UTF,
medicines) and
experience across the
Philippines
No exit strategy or
historical plans to build
capacity
Opportunities
Deliver complex
program with full
support and leadership
of local institutions.
Link core programs to
demonstrate the
benefits of an
integrated approach.
Continue support for
vulnerable communities
in Mindanao
Implement and support
ACF’s activities in an
integrated approach.
Work within tight
deadlines to get
program back on
schedule.
Build the capacity of
local health clinics and
skilled health
professionals.
Sustaining success in
ITP services given
sustained support
Build a sustainable
health service in the
Philippines
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Local
Centers
Health
Able to provide health
and nutrition essential
services.
Effective management
of OTP
Community
Health Volunteers
Ownership of activities
and dedicated to
helping their community
Farmer Groups
Sharing of farming
techniques including
indigenous methods
BAWASAs
Strong connection with
community
BMPU
Ownership of WASH
Representative of local
interests and cross
section of community.
Lack of Doctors and
limited resources and
trained nurses and midwives
Challenges to travel due
to lack of funding.
Limited Capacity
Renting land,
Low capital and limited
resources to buy inputs.
Limited capacity and
Knowledge of hygiene
practices
Apathy towards
government
Lack of skills and
access to training.
MPMU
Some technical skills
and planning authority
CTF
Budget and planning
power.
Limited understanding of
Development planning
process.
Slow bureaucracy
Limited connection with
local community
Restricted budgets and
poor timeliness of
activities
Limited transparency
and accountability.
Continue to deliver
services and provide
professionals post-ACF
program
Sustaining success in
OTP given sustained
support
Continue to maintain
up-to-date skills and
provide volunteer
services.
Utilise new techniques
in that may result in
short term loss of
income.
Maintain existing water
facilities and plan with
local government for
future works.
Be effective in
advocating local
institutions provide
social services.
Connect with local
communities and assist
planning and provision
of social services.
Transparent and
accountable Barangay
Development Planning
process and
implementation.
3.1.2 Overall Program
The design set out to create synergies in implementing the different program
components to improve the delivery of basic services, which aims to reduce poverty
in rural and peri-urban communities. The logic of the program is sound and
attempts to save time and resources and link all activities to reducing poverty.
Local, municipal and provincial working groups have supported the program. The
design and structure of local stakeholder groups is representative and well positioned
to help facilitate future ACF activities. Moving forward, theses groups need to feel
connected with ACF so each level of bureaucracy can add some value.
The evaluation observed PMUs working better at the local level where communities
are able to make quick decisions and act immediately. The evaluation met with
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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provincial and municipal government PMUs and these groups felt somewhat
disaffected, often only meeting once a quarter to receive reports from ACF. They
have limited involvement in the programs and often representatives send proxies to
the meetings. Better use of their time may be to include a case study from the
program and examine best practices or critical issues that need resolving in their
region. This promotes a more pro-active exchange and encourages fast solutions to
community problems. The evaluation would discourage future meetings that simply
lecture or present findings, but rather engage through participatory methods such as
simulations or group sharing exercises.
Included in the design of the cross-cutting issues such as good governance, is a
‘bottom up approach’, which translates to promoting community engagement and
discourse in the planning process, with the key result the creation of local
Barangay (village) development plans (BDPs). ACF’s design is to encourage greater
transparency and accountability of authorities from the community by promoting
involvement in the design and resourcing of key social services. ACF has a dedicated
resource person who is responsible for encouraging this process. More education
and advocacy is needed in the community to highlight the process of planning and
allocation of resources. ACF should also motivate communities to pressure
authorities to deliver planned services on time.
At the community level, the design of the program has been effective in focusing
on households with severely acute malnourished (SAM) children. ACF has
designed its nutrition activities around these households and as a result has already
made significant gains in reducing SAM children in the targeted areas. Other
activities including food security and livelihoods and WASH are aimed at improving
some of the underlying causes of poverty, which are poor household diet and limited
access to water and sanitation.
Food security activities were observed with farmer training and provision of some
inputs (tools and seeds) already complete. However, due to late cropping seasons,
poor harvest and some planning delays, the evaluation found farmers have made
limited progress on increasing food security4. Further analysis from the monitoring
and evaluation database indicates that no significant changes have occurred to
productivity. More results however are expected in the coming months as more
activities are rolled out. The evaluation recommends locally sourced and
appropriate inputs such as non-hybrid native seeds, organic fertiliser and
natural pesticides. Demonstration plots led by local farmers need to be supported
as well as small home gardens for vulnerable households.
ACF has already provided strong design to its WASH activities, indicated by
significant number of households with reliable access to water and sanitation.
Several schools have also benefited with over a thousand students are now able to
drink clean water and access new sanitation facilities. The design of hygiene
activities in the form of training and special events such as hand washing days in
4
Consolidated FGD and meetings with Farmer Groups during the evaluation period September 2012
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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schools has helped reinforce the importance of hygiene and its links to good health
and prevention of malnutrition.
The design moving forward needs to focus on a strong exit strategy and handing
over activities. This should be planned and co-led by local authorities in a
complementary approach with local partners. ACF should be encouraged by the work
at community levels and energy to move things forward. The big challenge will be
getting local authorities moving and providing real outcomes at the Barangay level.
Mentoring and a practical one-on-one approach would help engage busy local
government and prepare activities for handover.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.2 Sustainability
The sustainability of the program is still largely an unknown quantity and depends on
how well local institutions and user groups will continue to maintain and lead key
services established by ACF. This will be better known as the program is handed
over in approximately 12 months. The evaluation does however recognise that sound
decision-making and planning has provided the foundations for sustainable activities.
The big push from ACF over the next 12-18 months should be on mentoring local
partners and institutions by providing hands-on-leadership of program activities and
building the technical and administrative capacity. This should be complemented with
strong education and advocacy work in the following areas:




Leadership and active planning for nutrition and care practices, food security, and
WASH to address underlying causes of malnutrition.
Effective governance from local and provincial authorities and in-line with best
practice standards,
Increasing community pressure on authorities to improve transparency, and
Using performance indicators and audits to increase accountability.
3.2.1 Community Contributions and Counterparts
Overall, water committees or BAWASAs have demonstrated positive signs across
both regions by collecting funds to maintain existing water infrastructure as well
as follow up local authorities to ensure water supply. For example in village Proper
Kapatagan, the BAWASA committee has demanded support from the local
government, particularly through the village council leaders, so that they can be
allocated some budget for regular maintenance of the village water system and to
ensure inclusion of the budget for water maintenance in the Barangay Development
Plan (BDP).
Other internal initiatives for financial and in-kind contributions among households
have commenced. Some examples include:

For maintenance of tap stands and pipes, some cluster groups starting
collecting voluntary financial contributions (ranges from 5-20 Philippine Peso
(Php) from households. One cluster collected 300 Php, which they used to
buy rubber, couplings and faucet for repair of their tap stand. Other cluster
also started to collect voluntary contributions just in case repair would be
needed. The money is collected and held by the leader.

A village chief in Kapatagan had initiated planting of bamboos around the
main water source. He encouraged the BAWASA committee to take turns to
take at least a monthly visit in the area to ensure that the bamboo is cleared
from the water source.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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‘The LGU of Kapatagan have allocated a monthly honorarium at least for meals and travel
allowance of BHWs while at work. And, will be next lobbying for the honorarium for BNS’.
Beneficiaries’ and Local partners Learning Workshop Kapatagan
PMUs at all levels (Barangay, Municipal and Provincial) were informed of ACF’s
activities and provided in-kind resources to the program. The majority of these groups
recognised the need to address the key causes of poverty across vulnerable
communities as well as improving important cross-cutting issues such as local
governance. They recognise the need to strengthen government institutions capacity
to deliver key services that reduce poverty. Nutrition, Food security and WASH are
key areas they know they have to improve, however have historically struggled with
planning and design, timeliness of implementation, and managing limited budgets.
The PMUs established by ACF are keen to improve and represent an opportunity for
ACF and its partners to build new skills and delegate responsibility of the program to
local institutions over the next 12-18 months.
3.2.2 Government Focal points and skills transfer
Focal persons in local government have been identified and so far been effective at
setting up meetings and coordinating learning sessions.
In terms of nutrition, the evaluation found the ACF nutrition team had transferred
significant skills to the Rural Health Unit (RHU) staff across North Cotabato and
Lanao Del Sur. This is particularly evident from working with the RHU doctor, nurse
and midwife at municipal levels. Currently midwives provide direct support and
supervision of Barangay Health Workers (BHWs) and Barangay Nutrition Scholars
(BNS) who lead nutrition activities. This is a positive step in facilitating the delegation
of tasks to local partners. Furthermore, nutrition screenings were already using
MUAC and weight for height measurements and are now integrated with the regular
weighing at RHU level. ACF nutrition staff is continuing to provide supervision and
technical inputs, with gradual delegation of all supervision to local partners to be
completed by end of December 2013.
For the FSL program, ACF is striving to work in coordination with the Municipal
Agriculturist Officer (MAO) and at the local government PMUs. These are areas that
need to be strengthened in the case of Kapatagan and North Cotabato. In the case of
President Roxas and Arakan situated in North Cotabato a representative from the
Department of Agriculture has some disagreements with ACF’s approach to food
security, specifically highlighting that inputs are not always sustainable and farming
methods have been used before by other NGOs without success. Clearly there is an
opportunity to build this relationship and provide a strong focal point for the future of
ACF food security and livelihoods activities.
For WASH, the focal persons in government seem more or less to be ineffective in
both provinces proving little or no support in Arakan and President Roxas. In
Kapatagan in Lanao Del Sur the position has been vacant highlighting the lack of
priority for local government on WASH. There needs to be a push for ACF and its
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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partners to encourage the recruitment of a focal person, which should be the sanitary
inspector, under the Municipal Health Office (MHO).
3.2.3 Cooperation with Other Strategic Partner Organizations
At the community level, local partners such as MARADECA, Don Bosco, German
Doctors and Montaner hospitals work tirelessly to complete the work demands from
ACF. These partners provide a valuable connection with the local community and
ability to assess and select vulnerable households.
At national and international levels, the program coordinates effectively with the
National Nutrition cluster and with government agencies including the Department of
Health (DoH), Department of Interior and Local Government (DILG), and the
Department of Agriculture (DoA). UNICEF is also a strategic partner that resources a
proportion of the nutrition program.
3.2.4 Exit strategy and long-term approach
ACF has developed an exit strategy, though continued emphasis should be placed
on capacity building activities. An exit strategy should include extensive training
and one-on-one mentoring with allocated counterpart government and partner staff.
Potential strategies for reinforcing capacity building in local institutions to:

Engage at the design phase of the program or specific activities to provide
understanding on the principles and objectives of the program.

Provide links to industry leaders and associations that support agricultural
industries in The Philippines; so to strengthen local skills and opportunities for
trade.

Provide examples of best practice from other regions of The Philippines or
similar programs from other countries; so to provide ideas, guidance and
inspiration to community programs.

Involve local partners and local authorities in monitoring and evaluation; so to
provide understanding of program outcomes and impacts on the community

Mentoring and coaching in on technical skills and program management; to
improve ability to lead and implement programs.

Field-based practical training to demonstrate the implementation of
sustainable farming methods and construction of infrastructure.

Conduct early labour-market assessment to identify successful local private
and public enterprises. These entities could then be expanded or duplicated
and help address the challenge of expanding and scaling up of agricultural
output and identifying new market opportunities.

Attract and establish private-public investment opportunities so investment
can be made in business and public infrastructure. This will have a positive
effect on local stakeholders, as they must be competitive and therefore
improve their own capacity.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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
Continue to advocate local and regional government to provide adequate
infrastructure and provide financial and human resources to address a range
of local capacities in the public and private sector.
3.3 Relevance/Pertinence
ACF and its partners have delivered a much-needed program in remote areas
with limited services and previously high incidence of poverty. ACF’s mix of core
development initiatives is highly relevant to a population living in remote, poorly
serviced regions affected by conflict and with limited access to economic resources.
Lack of any real service delivery by local authorities and little confidence from the
communities provide a good basis for initiating an integrated program with crosscutting themes of good governance.
3.3.1 Target Population Degree of Satisfaction
The evaluation found a high level of satisfaction with ACF’s program. This is
probably not surprising given the lack of real assistance or support communities have
received. Nevertheless, ACF has provided real and relevant programming
addressing immediate and basic health/nutrition, food security and water and
sanitation needs of targeted communities across Mindanao.
‘Through the ACF program, our group members helped loan farm equipment to those doesn’t
own. The program provided a forum where we can discuss and share our farming
experiences with one another. It is a step towards developing mutual trust and caring that
would result in complete peace in our place’. Norodin Mudag, farmer, Lanao Del Sur
Target populations across Kapatagan, President Roxas and Arakan municipalities
have been very satisfied with nutrition, FSL, and WASH services extended in their
communities. Water infrastructure and farming activities had been all identified as the
priority need by the communities at the Barangay level. Across both Arakan and
Kapatagan there were some dissatisfaction with the delivery of some agriinputs, including use of non-native seeds to the area and purchase of expensive
organic fertilizer. Looking forward there is obviously a need to push for locally
sourced seeds and material for future farming activities.
Parents of previous SAM children were very happy after almost all of the children
were treated and returned to a healthy weight after admission to ACF’s nutrition
program. The number of SAM children in all program regions has fallen
significantly especially in second year of implementation, due mostly to early
detection and treatment by local health centers and mobile health volunteers.
‘We have received good training and support from ACF and we are now putting it into
practice. Local women and their children can now access health and nutrition services easily
without long distance of travelling’. Health Workers FGD President Roxas Datu
Sundungan
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Working in challenging terrain and under limited budgetary conditions local health
units supported by ACF and its partners have been able to provide health and
nutrition services on a free or affordable basis to vulnerable households. In addition
to treating SAM children, local health units have been able to provide nutrition
education and advocacy in the community. This work has complemented the
treatment and detection work being carried and contributed to reinforcing messages
of good nutrition and care practices.
3.3.2 Program Assessments
To ensure a more relevant program, ACF planned several assessments and surveys,
including a SMART survey, KAP surveys, and the Household Economic Assessment.
These were conducted by ACF or external organisations with some participation of
local government and the community. These baseline data have been collected and
were the basis in formulating appropriate and relevant program strategies as well as
utilising for mapping data. Mapping SMART data has been well received and
understood by local leaders who were able to easily understand progress through
visual aids.
3.3.3 Operational Strategy & context
ACF’s approach and methodology was relevant as it addressed key areas and is
encouraging communities to become self-sustainable in household nutrition, food
security and WASH.
ACF’s activities are implemented with full consideration of local custom and culture
and evaluation site visits illustrated appropriate construction of sanitation and WASH
infrastructure. Use of local staff and engaging local NGOs to lead program activities
has led to strong acceptance by the community.
The evaluation recognises the challenges ACF faced at the end of 2010 when
establishing programs at the same time as elections and high turnover of government
administration and local staff. Beneficiaries, local institutions and industry
stakeholders should continue to be engaged at the design phase of the program
or activities, to increase ownership of issues and solutions. In Annex 2, local Health
and WASH initiatives are highlighted by examples of local involvement in the design
and delivery of successful community nutrition and WASH programs.
ACF should improve the way they support their local partners. For example, the
teams of Don Bosco in North Cotabato felt that ACF simply ‘downloaded’ their very
busy work plan with limited support. Often the teams were only provided a tight work
plan and had limited involvement in the planning and little time to understanding how
integration fully works in the context of this program. Furthermore, various staff from
both Don Bosco and ACF would request meetings with several different government
officials to request the same information for WASH, FSL, Nutrition or Good
Governance. Clearly there is room for better internal communication and
integration of planning and administration of tasks.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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The evaluation believes ACF should continue with the planned gradual delegation to
specialist NGOs such as Don Bosco and Maradeca in collaboration with LGUs. This
provides greater learning and capacity across the NGOs and LGUs in design and
delivery of basic services. Ultimately, ACF should be promoting LGUs and local
institutions to lead programs and continue to step back from a reliance on NGOs in
the long-term.
3.3.4 Knowledge of the community needs
Overall, the program demonstrated sound knowledge and awareness of community
needs, local custom and the needs in child malnutrition, household food security and
access to water and sanitation.
Through baseline assessment of program areas and strong community facilitation,
ACF identified many households to be food insecure as a direct result of lack of
diversify in household diet, poor agricultural output, and limited access to water and
sanitation.
3.3.5 Geographical coverage and targeted population
Geographical coverage was relatively spread covering an independent component
city (Cotabato city) and two provincial areas (Lanao Del Sur and North Cotabato).
The main provincial areas are relatively far apart but facilitated by sub-offices and
guesthouses for staff to reside close to the program areas. The targeted population
was selected despite being in remote location, highlighting ACF’s goal of reaching
the most vulnerable. These communities represent some of the most vulnerable
and most impacted by conflict and generations of poor access to basic services.
3.3.6 Identification and targeting of beneficiaries
Beneficiary targeting amongst farming and water groups was sound and targeted
vulnerable households through Household Economic Surveys and vulnerability
assessment. Water infrastructure identification was supported well through village
water committees (BAWASA), which have already helped to plan and maintain water
tap stands, water sources and piping.
Targeting of government institutions at local, municipal and provincial levels was
effective and has provided representative bodies who are able to connect the realities
and challenges from community to decision making at government levels. This
structure is well established, however needs a big push moving forward to ensure
these local institutions feel actively engaged and are held accountable for their
actions.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.4 Coherence
ACF has taken practical steps to deliver a program that is coherent and ensures
different program components are integrated. ACF designed activities after sound
community needs assessment and consultation with local institutions. It has provided
some long-term strategic outputs including developing national nutritional protocols.
3.4.1 Formation of the Program Management Unit (PMU) at Different Levels
In theory these groups are well structured, but in practice more needs to done to
encourage more pro-active participation. This is particularly so at municipal and
provincial levels, were local government agencies and officials are only told of
program progress. This could be done by increasing the stake PMU and CTFs have
in these activities and encouraging more transparency to the public. Specifically, ACF
could encourage making meeting minutes, decisions and action-points public notice.
They could also co-chair and mix up these different levels of PMUs to share different
perspectives. For example, in the learning activities conducted in Arakan and
President Roxas for the evaluation, different groups (LGU, PMU, CTF, BAWASA)
were formed from a mix of participants. This provided a sharing exercise that
highlighted the importance of different perspective and working with different levels of
government and community.
3.4.2 Steps taken by ACF to integrate different program components
ACF has successfully added nutrition into its programming within an integrated
approach to tackling reducing child malnutrition. This has translated to a reduction in
child malnutrition with further progress being made to develop the local capacity of
health units to continue detection, treatment and prevention of malnutrition.
ACF has actively participated in the national nutrition cluster meetings and in a
series of workshops to draft and finalise The Protocol on Philippine Integrated
Management of Acute Malnutrition (PIMAM). It has been submitted to the
Department of Health (DoH) Secretary and is waiting approval. In the meantime, ACF
promoted the use of Integrated Management of Acute Malnutrition (IMAM), which is
being integrated to the existing IMCI services at local health centers, which include
the midwives and community workers (BNS and BHWs) managing the OTP centers.
ACF has also contributed in the development of a user-friendly pocket tool on
nutrition management in emergency/ disaster, which will provide guidance on
implementing nutrition responses in the field during emergencies.
Food security activities experience mixed success to date with harvests impacted by
poor weather, external inputs and lack of training on fertiliser production, limited
seeds saving, and lack of demonstration plots. In the 2011 harvest, ACF was running
short on time before the end of the planting season in Arakan, North Cotabato and
encountered a lack of available seeds. As a result ACF was only able to source
seeds from outside the region of Arakan. These seeds failed, coupled with application
of too much fertiliser brought in from outside. Seed banking and seedling production
could be utilised to mitigate these issues and provide a more food secure region.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Moving forward, food security activities need to embrace more locally sourced and
produced organic fertiliser, utilise seed saving initiatives and local farmer led
demonstration plots. These FSL activities must be complemented with education
and advocacy to link food security to household nutrition.
WASH and hygiene promotion provided education on hand washing and proper
sanitation, which complemented some of the nutrition and care practices. This
component could be expanded further to include some related child health
messages including anaemia, worm infection and dysentery.
ACF has been careful to consider previous actions in the current intervention
areas. Design and planning has taken into account previous work ACF has
completed across the Philippines and in other regions. ACF has a strong track record
of implementing Nutrition, FSL and WASH programs in vulnerable communities
across development settings, so lessons learnt and case studies were examined
early in the program. Following on from this assessment and understanding, a
standard operating guideline was developed to provide a clear and defined set of
rules and expectations for the program.
ACF has coordinated well with other agencies, institutions, government entities,
and NGOs. It has taken several steps to ensure activities are coordinated including
formation of PMUs, participating and leading in cluster meetings for nutrition and
agency meetings for Mindanao. ACF staff appeared to be well connected with local
partners and indeed some have significant experience working with them in key
sectors and regions of the program.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.5 Effectiveness
The program over the last two years has built an effective foundation for improving
socio-economic conditions that address malnutrition, food security, water and
sanitation, and good governance for over 7000 vulnerable households across
Mindanao.
Targeted households now have reduced levels of child malnutrition by over 90%5 and
now able to access more effective local nutrition and health services. Over 9006
farmers have received farming inputs (seeds and tools) and training in farm and
business planning. Local water committees or BAWASAs have been established and
are contributing to maintaining and providing communities and schools access to
clean and safe water. Local institutions have started to get more involved with ACFs
program with more work to follow to build strong apparatus that will deliver basic
social services.
3.5.1 Nutrition
Nutrition activities have contributed to significant reductions in child malnutrition. In
the table below all three, municipal program areas have demonstrated a large drop in
the number of severely malnourished children (SAM) detected.
Municipality
2011
2012
SAM
SAM
SAM
SAM
Detected
Treated
Detected Treated
Arakan
99
95
11
8
President Roxas
56
56
11
8
Kapatagan
52
52
7
7
Total
207
203
29
23
Table 1: Number SAM Cases Detected and Treated (taken ACF’s July 2012 Monitoring report)
The evaluation recognises the success of this drop through the capacity building of
local health clinics, provision of education and therapeutic feeding program, and
development of human resources such as community volunteers in health and
nutrition.
3.5.1.1 Nutrition before ACF Program
Based on Household Economic Assessment conducted by ACF before the
commencement of program activities, households were able to cover their food
requirements but household diets are extremely high in carbohydrates (rice, corn,
tuber), low in vegetables and protein. This shows a high risk of food insecurity during
disasters or acute change and support initiatives that involve distribution of vegetable
seeds, planting of leguminous seeds (for protein) and a variety of local fruits, and
livestock development.
5
6
Based on figures collected in ACF July 2012 Monitoring data and discussion with Rural Health Units.
Based on ACF 1st Monitoring July 2012 Progress Reporting
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.5.1.2 Tackling Malnutrition
The program’s success is highlighted by a significant reduction of acute malnutrition
in the target communities. In doing so, the program has effectively promoted the
mainstreaming of IMAM (Integrated Management of Acute Malnutrition, within the
IMCI (Integrated Management of Childhood Illnesses), which is a regular program of
Department of Health’s – Rural Health Unit (RHU). This is also referred to as the
integrated IMAM-IMCI, which includes prevention, detection, referral and
treatment of acute malnutrition.
Referral systems have been set up in the target municipalities through Out-patient
Therapeutic Program (OTPs) integrated at the RHU and Health Centers/Stations
of each target municipality and stabilization centers at hospitals serving as Inpatient Therapeutic Program (ITPs). SAM patients without complications were
referred to OTPs and SAM patients with complications were referred to ITPs (i.e.,
Montaner hospital in Lanao del Sur and German Doctors hospital in North Cotabato).
The implementation of the integrated IMAM-IMCI, in general resulted in
strengthening the operations of the local health structures not only at RHU
(municipal) level, but also at the Barangay health stations (BHS, village level). This
includes enhanced capacity of the health staff, paediatric nurses, midwives and other
volunteer staff at RHU, such as the BHWs and BNS.
ACF nutrition team has provided effective trainings and necessary technical
support, including the improvement of relevant recording and reporting needs.
UNICEF has effectively supplied some basic medicines, therapeutic foods and
anthropometric materials, though a long-term sustainable supplier is needed from
local health and government authorities.
3.5.1.3 Functional OTP and ITP
Success can be attributed to the increased nutrition screening and referral system of
SAM (severe acute malnutrition) children. This process has now been
institutionalised with the establishment of OTPs at the Rural Health Units and Health
Centers/ and an ITP at German Doctors German Doctors’ Hospital (North Cotabato)
and the Montaner government hospital (Lanao del Sur). The number of OTPs
established has increased and shown in the table below. It demonstrated a significant
increase in the number and access for communities who were previously isolated
from basic health services.
Municipality
2012
st
nd
Total
1 Qtr
2 Qtr
Arakan
4
6
7
17
President Roxas
4
6
5
15
Kapatagan
3
0
0
3
Total
11
12
12
35
Table 2 Number of functioning OTPs set-up at RHUs and Health Centers/Stations with access to
RUTFs and routine medicines
2011
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.5.1.4 Improved Capacity of Health Center Staff
Overall, Rural Health Unit staff expressed their confidence and improved knowledge
in nutrition screening and treatment of SAM patients. Growth monitoring using the
MUAC and weight-for-height/length are new technical skills they now utilise, and
complemented their old system of weight-for-age only. Treatment of referred SAM
patients had been effective, particularly with the availability of medicines, vitamins,
weighing scales and Ready-To-Use-Therapeutic-Food (RUTFs), which had
previously been in short supply. Moving forward, more training and one-on-one
mentoring of BHWs and BNS through RHU staff is needed to reinforce and ensure
best practice and a sustainable service is provided post ACF support.
Photo 1: Functioning OTPs in Lanao Del Sur Province
3.5.1.5 Improvement of IYCF Practices
The improvement of IYCF (infant and young child feeding) practices; particularly of
SAM patients who have been treated and recovered will be an important measure
for follow-up to assess program impact. There is no program data yet to validate
the changes, however the next KAP survey will be conducted at the end of 2012 to
provide data for analysis.
For future monitoring of IYCF, SAM patients who have recovered and the MAM
detected should be the main focus. The findings in the KAP survey should help
define a simple set of verifiable indicators that can monitor changes in breastfeeding,
complementary feeding practices of young children, and care of pregnant and
lactating mothers.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.5.2 Food Security and Livelihoods
As of July 2012, the program has provided 986 farmers with access to tools and
typically provided seeds such as corn, rice and various vegetables seeds like
eggplant, squash, okra, and bitter gourd. The table below illustrates the proportion of
farmers selected in each municipality. Changes to date have been modest with
production steady or down due to cropping failure, monsoon weather or program
delays. Farmers have been overall happy with the program, which has provided new
skills in organic and sustainable farming, fertiliser production, farm planning. Moving
forward, greater focus should be placed on locally sourced inputs and organic
farming. Furthermore, ACF should push advocacy for non-hybrid seeds and natural
pesticides, and leadership from the DoA and supporting agencies.
Municipality
Target # of
Beneficiaries
750
750
500
st
1 Batch
Total # of
Beneficiaries
Agri
IGA
Arakan
235
129
364
President Roxas
135
240
375
Kapatagan
224
23
247
Total
594
392
986
st
Table 3. Beneficiaries of 1 batch of Agriculture and IGA inputs
3.5.2.1 FSL situation Before ACF
Prior to ACF programs, farmers have been using conventional ways of farming
including: reliance and prolonged use of commercial fertilizers and chemical
pesticides, mono-cropping (mainly corn and rice with coconuts, banana, cassava),
and using slash and burn techniques. These have all contributed to poor soil
conditions, an increased in pests and reduced long-term farm productivity. There was
a lack of knowledge of other farming system and lack of support from local
institutions. Typically less then 50% of farmers don’t own their own land and resort to
borrowing money for farming inputs often resulting in large debts to the landowner.
3.5.2.2 Farm and Business Planning by Beneficiaries
A total of 986 beneficiary farmers have been trained on sustainable agricultural
techniques and developed farm and business plans. As indicated in the table below,
over 95% of the target farmer beneficiaries who participated in the trainings have
produced their farm and business plan. After developing these plans, ACF identified
the relevant agricultural and off-farm needs to be provided to farmer beneficiaries.
The majority of target farmer beneficiaries received various seeds, farm tools and
sacks of organic fertilizers. Moving forward, ACF and its partners must ensure these
plans are implemented. Support and leadership from DoA and local institutions need
to assist to ensure crops are successful and marketed effectively. ACF needs to
facilitate to reduce the perceived barriers between farmers and DoA caused by
mistrust and lack of historical support from local government.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Municipality
Agri
Beneficiary Farm Plan
Developed
Arakan
235
235
President Roxas
134
134
Kapatagan
224
224
Table 4. Status of Farm Plan and Business plans
Beneficiary
129
240
23
IGA
Farm Plan
Developed
114
240
23
Total Plans
Developed
349
374
247
3.5.2.3 Effects on Farmers’ Yield
Up until August 2012, there has been mixed success in crop yields across all areas
of the program. Many farmers had not yet planted their seeds due to an extended
rainy season. Farmers who had planted after distribution noted poor results
especially with corn when planted with purchased organic fertilizer sourced by ACF.
Those who used the purchased imported organic fertilizer reported poor corn yields,
which discouraged other farmers to try to use the organic fertilizers. Those who
planted corn but did not use the organic fertilizer achieved better yields. Moving
ahead, ACF should discourage the future purchase of imported organic fertiliser by
NGOs, but instead provide training to farmers on the production and proper
application of locally sourced organic fertiliser.
‘We used the fertiliser and seeds provided by ACF but our corn grew fast early, however
turned yellow, died and produced no real crop’. Farmer from Farmer group Arakan, North
Cotabato
From discussions with Municipal PMUs the evaluation would recommend immediate
follow-up to train famers on proper use/application on site. In addition farm site visits
should be conducted by the PMU and MAO before production and application of
fertiliser.
The evaluation also recognises that ACF had to provide alternative seeds for
vulnerable households when local seeds were not available, however would always
encourage locally sourced non-hybrid and non-genetically modified (GM) seeds.
There is an immediate and long-term need for seed savings and seedling production
to mitigate shortages of essential crop seeds. This is something that is cheap and
easy to replicate by local farmers and can be easily supported in ACF’s existing
program. This would provide a short-term safety net for household food security to
manage the risk of crop failures or loss of temporary livelihoods.
3.5.2.4 Formation of Farmer Self-Help Groups
The formation of farmer groups was productive as it enabled sharing of issues and
an association that is able to represent at various levels of government. The
evaluation found these groups useful and should be encouraged. However, there is
an underlying lack of connection between the farmer and key agencies such as the
DoA. This is perhaps one challenging task, which ACF’s good governance activities
need to address in order for better planning and support for many subsistence
farmers.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Photo 2: Farmer Help Groups participate in organic corn planting in Arakan Cotabato
3.5.2.5 Future FSL Opportunities
Moving forward, more focus should be placed on developing demonstration plots and
farmer field schools led by local farmers. Success is contagious, so demonstrating
successful methods in the community will enable other farmers to learn and replicate.
This process should be led by lead famers in the community, and supported by a
partnership between farmer groups and the DoA.
Often, successful indigenous practices are forgotten by local farmers and not
considered by NGOs. ACF and its partners should assess existing successful
practices and use locally available technologies when planning farming activities.
These may include production of organic fertiliser with local manure and organic
materials, natural pesticides and cross planting to discourage insects.
The Program should consider supporting other Income Generating Activities (IGA)
such as value adding support businesses. ACF conducted a household survey and
market study but hasn’t fully utilised the findings. There must be several opportunities
buried in these studies to develop more than just farming businesses. For example,
Household Economic Study produced findings that recommended priority for
alternative IGAs including livestock raising and post harvest businesses such as
milling. These need prioritising in the next 12-18 months to expand livelihood
opportunities.
For the whole local economy to grow there must be a more diverse range of industry
and supporting business. A good example of this is ACF’s ‘Solid Waste Management
Program’ in Cotabato City, Mindanao. There is opportunity to expand this into other
regions and material such as plastics and metal. The same applies to expanding agribusinesses to areas of Kapatagan, which currently have no added IGA activities up
until July 2012.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.5.3 Water, Sanitation and Hygiene (WASH)
ACF has provided essential water and sanitation facilities to remote communities
across Central Mindanao in Lanao del Sur and North Cotabato that have shown
significant impact. The table below illustrates completed work including six water
sources and over 60 tap stands. The program has also supported six schools with
toilet and sanitation facilities. The evaluation found these facilities to be in mostly
good condition and functioning well in North Cotabato however in Kapatagan there
was a school toilet with no faucet in tap stand for washing. Hygiene activities have
impacted on the behaviour with teachers and health workers reporting reduced levels
of dysentery and infection at schools and in the community. There is however
improvements needed as the RHU in Kapatagan reported 24 cases of diarrhoea in
2011 and 30 cases as at June 2012 for children less than five years of age. This is
still high and could be linked to the lack of toilet facilities in homes, threat of
contamination due to lack of regular monitoring.
Table 5. Water Systems and Tap Stands Completion and Coverage (taken from July 2012
monitoring report)
3.5.3.1 The Situation Before ACF’s program
Many, families described their situation before ACF WASH activities in the community
as difficult and very challenging, as they had no access to safe drinking water source.
Typically families relied only on only one source of water or spring usually located in
the highlands often an hour or more walk. Regular bathing of children was difficult
with parents describing their children as always being dirty. Washing of clothes
typically done by women was difficult, as they would have to physically walk up a hill
to the main source. Household gardens were not possible as there was simply not
enough water.
3.5.3.2 Impact on the Target Population
Families, particularly women, were very happy that they are able to wash daily and
supply clean water to their children. They could regularly wash their clothes and start
planting small home gardens. Children are now clean and according to community
leaders in PMUs and health workers incidence of diarrhoea has been reduced.
The establishment of Water Committees (BAWASAs and cluster household users)
has overall helped to maintain water tap stands. The groups have collected small
funds to regularly clean and maintain community water infrastructure. There is an
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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increased sense of ownership and value of belonging to a trusted organisation
providing an essential social service.
The evaluation found that the communities were actively engaged in the planning
and design of water infrastructure. In an exercise during the evaluation held in
President Roxas, Arakan and Kapatagan, the BAWASA committee and households
were able to demonstrate water plans and highlight the roles and responsibilities of
the BAWASA and water users. The below figure illustrates the water planning
evaluation FDG conducted in Kapatagan.
Photo 3: Water planning during evaluation in Kapatagan (during Evaluation Learning session)
3.5.3.3 WASH in Schools
Prior to new water supply and toilets established in several schools, teacher reported
a high number of sick students and hygiene problems associated with defecating in
open areas. Now, in most areas functioning toilets are impacting positively on over 12
school representing thousands of students as proper sanitation facilities keep
students safe from disease. Access to clean and safe drinking water has also helped
students stay healthy and reduce levels of dysentery and infection, which can be
passed on in the household and lead to further malnutrition. This is less so in
Kapatagan indicating more work is needed to reinforce messages and improve
existing WASH infrastructure.
Sustainability of hygiene promotion to date is sound, demonstrated by functioning
facilities and demonstrated practice by students. However with initial support from
ACF, messages need to be continued by teachers and school administrators for
future students to continue good hygiene practices.
The evaluation found one unresolved issue. In Kapatagan, a water pipe connection
at a school had been deliberately cut off and a water tap stand faucet had been
stolen. The school was forced to close the two toilets. ACF need to ensure ownership
of these activities and any outstanding issues are addressed to avoid this in the
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
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future. ACF are however hopeful that the landowner, school and the BAWASA can
resolve these issues before the end of the year.
‘School Administrators should be able to maintain and look after toilet and water sources near
their schools, just like household clusters to maintain local water and toilet facilities‘.
Members of BLGU village Proper Kapatagan
3.5.3.4 WASH Opportunities
WASH initiatives and its approach are good practices that can be replicated in other
LGUs. Bringing water to communities has probably the most impact on household’s
vulnerability. Water provides more opportunities for families to drink and use safe
water, grow home gardens and have access to year round water supply. Within the
WASH approach, the BAWASA with household user groups is a great forum for not
only promoting ownership and maintaining tap stands but also a good connector for
community dialogue and progress in other areas. These areas include but not limited
to food security, good governance and peace building initiatives.
3.5.3.5 Most Significant Change in the Community
Feedback from the community has been very positive. As part of the evaluation, staff
and partners were asked to contribute by writing a ‘most significant change’ story,
which reflected on their experience and highlighted the most significant changes in
their household.
‘I thought my son had no hope of becoming healthy after being a SAM. Now, I ensure my
children have nutritious food so the disease would not recur. If they feel something unusual I
immediately bring them to the local Health Center. My knowledge has been enriched
especially in the proper care of my children and how to be healthy and how my family avoid
being sick’. Aileen Kasan, mother of the first SAM child identified in Barangay Daguan,
Kapatagan
‘Now, I am able to conduct hygiene promotion sessions and I am also helping in Promotion of
Good Nutrition (PGN)’. Dhalia Buned Local Health Volunteer, Barangay Datu Sundungan,
Pres. Roxas
‘I received corn, farm tools, mung-bean and seven types of vegetable seeds. I learned
practical technology for poor farmers and sharing my knowledge to other farmers.’ Leny
Oyao , household farmer Centro, Ganatan, Arakan, North Cotabato
Of the 30 responses collected, all indicated an overwhelming positive response to the
program, highlighting improved child nutrition and health, access to water and
increased opportunity to contribute to local decision making and planning in their
communities. A sample of these stories is listed in Annex 2.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
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3.6 Efficiency
Overall, the program has been efficient with overheads at approximately 30%7 of total
program costs and a sound beneficiary-cost ratio of approximately 1008 Euros. The
majority of staff are locally engaged and reside close to the program sites for an
effective field based approach.
3.6.1 General efficiency
The program has not significantly increased any agricultural production or household
income due to food security initiatives, however it has provided significant water and
sanitation infrastructure with co-contributions (cash or in-kind) from communities
across the program area. Malnutrition activities are very cost effective as provision of
services is supported through a large local volunteer cadre.
ACF staff reported efficient use of management tools to assist with administration,
budgeting, and reporting. However too many activity based indicators and survey
tools increased time pressure on local partners and ACF who spent a significant
amount of time collecting data.
The budget for the program (4,000,000 Euros) is cost effective and relevant when
assessing the wide range of activities ACF implemented in the remote regions across
Mindanao and coverage of over 7000 household beneficiaries. The evaluation
considers program outcomes to date value for money, particularly when considering
the long-term benefits of improved nutrition, access to water and food security for
several thousand vulnerable households.
Partnering with local NGOs Maradeca and Don Bosco has been efficient and
enabled activities to be implemented and closely monitored. ACF provided training
and field supervision to enable partner staff to lead and implement training capacity
building activities.
3.6.2 Cost efficiency

The average of cost of activities per beneficiary was appropriate compared to
other regional ACF activities.

The number of staff and local facilitators was appropriate and has helped to reach
communities in remote areas. Overheads seem fair and reasonable and in-line
with similar ACF development programs in The Philippines and across other
regions.

The program could reduce the cost per beneficiary by promoting further
investment from the households and local institutions. This may also increase the
buy in and ownership of agricultural activities, however household vulnerability
may limit people’s ability to invest.
7
8
From ACF Program Proposal budget 2010
4,000,000 Euro divided by approximate 7000 Household (approximate 6 persons per family)
=4,000,000 / 42,000 people equals 95.24 Euros
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
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
Logistical, financial and procurement is functioning well and ensuring best value
for money materials and equipment were provided. Communities were overall
satisfied with inputs such as seeds, tools and water infrastructure.

The overall budget is moderately under spent due to program delays in the early
part of 2010/11. Otherwise, budget was spent as intended and in accordance with
the budget and program proposal.

Nutrition, Food security and WASH teams worked well, however they need better
communication and planning to avoid duplication when dealing with institutions
such as municipal and provincial governments.

Local partner should be involved in the initial planning and continue to be
provided administrative and management support in the field to save time and
resources and avoid any duplication.

Sound systems in place to record, report and track spending and procurement
systems to prevent and identify corruption.
To improve efficiency of providing inputs, ACF plans to utilise vouchers. This would
enable farmer beneficiaries to choose which seeds or agricultural tools were needed
and the right timing. ACF would provide a list of reliable suppliers and time period for
redeeming. The voucher would replace the direct distribution by ACF of agricultural
inputs and tools to farmers, saving time and resources and providing some flexibility
and shifting decision making and responsibility to farmers.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.7 Involvement/Participation
The program has overall experienced strong participation and involvement from
the community, through formation of community groups helping to implement,
maintain and support activities. Outside of the traditional ACF activities, cross-cutting
components such as good governance have developed the foundation for better
delivery of social services. The formation of PMUs at various levels of government
stakeholders has helped to facilitate the implementation of activities across the
program.
Nutrition has seen the formation and strengthening of community health and
nutrition workers groups both volunteer cadre and paid staff. Community health
volunteers have been well mobilised in coordination with RHUs, local partners
Maradeca, Don Bosco and LGUs. Over 50 BHWs (Barangay Health Workers) and
BNS (Barangay Nutrition Scholars) are now operating across targeted villages.
Before ACF’s program, there was no real effective system or support for nutrition or
basic care practices. The BHWs and BNSs have filled this gap and provided strong
support especially in the key area of nutrition screening of young children (6-59
months) and referral of SAM patients to either the OTP or ITP.
‘We are happy that with the arrival of this Convenio Program, it has changed a lot of things
among the communities and within RHU that resulted in greater access to health and nutrition
for families and fewer cases of malnutrition’. Dr. Ashar Dimapanat, Municipal Health
Officer, Rural Health Unit, Kapatagan, Lanao del Sur
Food Security and Livelihoods activities have engaged over 900 household and
working farmers to form small support groups, which have been active in attending
technical and administrative training, and trying new techniques introduced by ACF
and its partners. Moving forward the evaluation would recommend more
demonstration plots and formation of identified successful lead farmers to teach other
farmers. The basic principle of ‘see one - teach one - do one’, can be an effective
approach to put FSL ideas into practice and demonstrate to the wider community.
WASH activities have been successful in gathering community interest, forming
water user groups (BAWASA) to maintaining the infrastructure and facilitate the
provision of hygiene messages. Moving forward the BAWASA should continue to
facilitate, particularly in areas of Kapatagan the monitoring of water quality
inspections and encouraging ownership by schools of water piping and toilet
facilities. Overall, communities were most engaged and enthusiastic about WASH as
the benefits are immediate, lasting and impact on all aspects of household’s
livelihoods.
‘We can organise to raise funds to maintain and clean the water source and tap stands. We
are leaders in the community and are members also in the farming and LGU groups so we
can share issues and concerns ’. BAWASA Tumanding Arakan North Cotabato
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
35
Key government stakeholders such as BPMU and MPMU participated well and
helped facilitate a relatively smooth start to the program implementation. Specifically,
they helped to involve different actors and mobilise communities. MOUs that were
created demonstrate commitment from targeted BLGUs, government line agencies
and local partners.
The PMU meetings at different levels served as a good mechanism to raise and
discuss program issues and solutions. Moving forward the evaluation would like to
see more effective participatory approaches used to encourage activities to be led or
co-led by relevant institutions. The program faces continuing challenges such as
ensuring regular participation of representatives, ensuring a smooth transition of
PMUs to the existing LGU structure and guaranteeing some form of ongoing
accountability and transparency of government.
Success in participation and community involvement has contributed to the
development of Barangay Development Plans (BDP) and the Municipal Annual
Investment Plans. The process was successful in facilitating participation with
community groups in the design of social services including Nutrition, FSL and WASH
initiatives. Groups were able to engage with local and municipal authorities to finalise
the plan and provided community groups an opportunity to oversee and ensure all
issues were debated and taken into account.
‘There is enhanced local skills from people in the community and direction from the local
government. It is now a little easier to implement programs that address needs of
communities, with emphasis on health and nutrition, livelihood, and WASH”. Local
Government Representative at MPMU level in Arakan
The local government recognises it must do more, however evaluation believes this
area of the program needs a big push in terms of advocacy and human resource
support in the next two years. This will help communities push government to be
accountable and ensure they realise the dividends of local plans.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.8 Control
The design of the program has established a wide range of activity monitoring and
evaluation (M&E) indicators that is good for internal purposes but might detract from
the goals of the program. The time taken to collect and analyse the information isn’t
clearly defined in the design and may lead to partners and ACF staff spending a lot of
time collecting data instead of managing the activities. The LFA itself (in terms of
objectives and activities) does not need to be greatly modified, but only the amount of
monitoring data collected. Monitoring data from ACF is fully reported up its
institutional donor but is neither fully participatory and feedback from and to
communities isn’t clear.
The evaluation recommends (2-3) indicators for each sector to focus more on
results based monitoring and answer the question of ‘Is this program succeeding?’
Indicators should directly address the two objectives of the program and measure
key indicators such as the following example; a) % changes in acute & chronic
malnutrition levels; b) % changes in water-related illnesses, and c) % changes of
direct beneficiaries income/available food stock.
Use of local communities, local facilitators or local PMUs for monitoring collection
was not clear, as were any involvement in the design, management or
implementation of monitoring and evaluation of the program. A more defined,
focused and local stakeholder co-led M&E system would add value and increase
ownership of delivery of social services. A good example of this would be the farm
and business plans developed by farmers. If done well this could be a good initiative
to start a monitoring tool that farmers in the field could follow up and monitor
themselves.
The evaluation was encouraged by the use of mapping data in the design, which has
been well used to illustrate regional differences in malnutrition, something that is well
utilised by local government leaders.
Improvement to the health and nutrition monitoring may include measuring the
success of the IMAM protocol integrated in the RHU. This can be used as a control
tool developed into the system for measuring effectiveness. Efforts to promote and
include PIMAM at a national level should also be measured and included in the
overall impact of the program.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.9 Integrated focus
Overall the program has established sound organisational structures and prepared
staff and partners for this new integrated approach. Moving forward hard work will be
needed to educate the wide range of stakeholders about the benefits of an integrated
approach across this wide reaching program. Demonstrating results will be key as
many communities and government groups may be cautious of new approaches and
techniques.
The program has experienced some delays in delivery of some activities and
impacted on the integrated focus of the program. On several occasions activities
have been put on hold due to circumstances beyond ACF’s control such as security
and conflict, monsoon weather and political campaigning. Some programmatic
delays have also occurred, mainly as a result of the extra time needed to gather
groups and work with local government structures. The PMUs, represented by a
range of local government and line agencies are not always available and willing
participants, particularly at the municipal and provincial level. More work will be
needed in the next two years on strengthening these areas to become pro-active
and competent institutions. This is particularly a timely issue as the handover of
activities fast approaches in mid 2013.
The nutrition component has worked well to link local structures with locally
appropriate practices ensuring communities have access to health and nutrition
services. Links with food security are yet to be fully realised as many households are
not yet involved with any home garden or livelihood activities or have seen the results
of an improved harvest. However, the program has successfully provided some
training in food diversity and care practices for mothers and their children.
Food security initiatives particularly agricultural productivity has seen mixed success
as poor seed choice, bad weather and new farming techniques are introduced and
improved. There has been some success in developing small gardens but more will
be needed particularly when linking household nutrition to diversified diets and home
gardens.
‘People are realizing and are starting up backyard gardening, as a support to prevent
malnutrition among children’. Beneficiaries’ and Local partners feedback during the
Evaluation Learning Workshop in Kapatagan
‘Communities are working together to solve problem of malnutrition resulting in a more
healthy family and peaceful community. More people are involved in community groups such
as farmer groups, BAWASAs, BLGUs, and health committees’. Beneficiaries and local
government from President Roxas.
Moving forward ACF and its partners will need to be more effective in using locally
available inputs and existing skills from local farmers and indigenous groups. ACF is
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
38
yet to fully realise the potential benefit of linking food security and nutrition.
More education and advocacy needs to highlight these important links especially for
households with SAM children or at risk of malnutrition.
Water and Sanitation activities are progressing well with water infrastructure in
North Cotabato province and some in Kapatagan already complete and community
ownership established. Hygiene programs in communities and schools are
underway and demonstrating sound results with generally lower rates of infection,
diarrhoea and dysentery as reported by health clinics and school administrators.
More work needs to be completed in Kapatagan as they attempt to complete all
WASH infrastructure and maintain good hygiene practices.
‘My pupils were often absent or would dropout because they got sick. Sometimes they go to
school without taking a bath. After ACF arrived, our school received a water supply and toilet.
The pupils also no longer go home for them to urinate and defecate. They can concentrate
more on their lessons’. Volunteer school teacher in Bongabong Elementary School and
a Community Hygiene Promoter of ACF
‘There is increased knowledge on the importance of clean and safe water for personal
sanitation and hygiene.’ Beneficiaries’ and Local partners feedback during the Evaluation
Learning Workshop in Kapatagan
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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3.10 Cross Cutting Issues
3.10.1 Gender
The program is overall sensitive to gender issues and female participation has been
a central focus during program design and implementation. Over 50% of the
BAWASA, farmer groups and local BLGUs are representative of women.
Mothers and their children were a focus for the program particularly on nutrition and
health initiatives and were well included in the planning and design. Women who
were pregnant, lactating or the primary care taker were targeted for the nutrition and
care practice and were central to the nutrition activities with measurements such as
weight and health of their children a core part of program activities.
ACF included gender when developing the contextual analysis for the program. It is
very important to include women in food security activities, as they are generally the
ones who work the gardens, manage the kitchen and prepare the meals.
3.10.2 Children
Children are a main focus of program with detection, treatment and prevention of
child malnutrition at the forefront of contributing to poverty reduction. Reducing child
malnutrition is a central element factored into the design of the program. The
program also provides school WASH activities including hygiene promotion and
provision of clean drinking water and toilets. This has contributed to healthier children
and clean and safer school environments.
3.10.3 Cultural Sensitivity
ACF understands the cultural context of the different regions of the program, taking
time to understand the local custom and language. It has demonstrated good cultural
sensitivity and effectively utilised local staff and partners to lead appropriate and
sensitive communication to build strong local relationships.
3.10.3 Disaster Risk Reduction (DRR) and Environment
ACF spent considerable time at the commencement of the program to ensure DRR
elements were incorporated into the program and in line with national DRR policy.
These elements include watershed and water source management, which ensured
water sources were kept clean and free from debris. Regular testing and
maintenance in partnership with the BAWASA ensured water sources were safe and
free of contamination. Furthermore, ACF ensured all WASH infrastructure was built
not to cause damage to the environment. For example ACF built erosion control
measures to avoid damage to the water source and mitigate the risk of landslides.
Moving ahead, future DRR activities should include food security initiatives such as
seed saving, seedling production and a bigger push for home gardens. This is
particularly important for food insecure households with SAM children.
Complimenting these activities is education in the growing, preparation and
consumption of a nutritious and balanced household diet.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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4.0
CONCLUSIONS AND RECOMMENDATIONS
Overall, ACF has provided a solid grounding for delivering an integrated mix of
nutrition, food security, WASH and good governance initiatives to tackle poverty in
rural and peri-urban communities. ACF and its partners have commenced a new
approach to mainstream cross cutting issues such as good governance into its
programming, which is encouraging local institutions to deliver social services. The
program has taken positive steps to promote community empowerment and
leadership in local planning and as well as accountability of local institutions.
The following outlines key recommendations from ACF’s experience in Mindanao,
which will drive planning and implementation strategy for the next two years of
program.
Nutrition and Care practices

After discussions with health care professionals and community volunteers,
ACF should advocate to RHU the use of the existing ECCD (Early Childhood
and Development) card to include key nutrition information and enhance it by
adding pictures of signs of SAM. Informing and guiding mothers on how to
use it would increase the usability of the ECCD. A more visual and easy to
use growth card is a good self-monitoring tool for all households and should
be highly encouraged. However, parents that were interviewed often did not
fill out the nutrition card, so more advocacy and education needs to support
this initiative.

After observing communities and examining current food consumption from
the Household Economic Assessment, ACF should promote backyard
gardening for multi-cropping of nutritious local leguminous seeds such as
peanuts, mung beans, and variety of local vegetables and fruits to improve
the dietary intake of households. All households with SAM children should
be prioritised as beneficiaries for food security and WASH to reinforce ACF’s
integrated approach at the household level.

From discussions and observation with health care professionals, ACF should
closely monitor SAM children through home visits and visits to the RHU.
This will ensure a sustained recovery of SAM children. There is a need to
follow-up child feeding and care practices to ensuring nutritious food is
prepared for children, and adequate fruit and vegetables are being grown or
sourced for household consumption.

From observarions at health clinics improvements should be made to IYCF
(infant and young child feeding) practices, to continue to promote early
initiation of exclusive and continued breastfeeding; and appropriate, age
specific complementary feeding and dietary diversity.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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Food Security and Livelihoods

From observations and discussions with farmer groups, ACF needs to focus
on using locally sourced input and appropriate technology. Encourage the
use of native non-hybrid, non-GM seeds and source organic manure locally
for production by local farmers. This will reduce costs to the farmer, ensure a
sustainable approach to earning an income and will eliminate damage done
to productive land.

After site visits and discussions with farmers, there is a need to reinforce skills
and training received on food security and agricultural activities. This can be
done through demonstration-farming plots using a farmers-to-farmer
approach for training. The approach should also utilise successful indigenous
practices and locally sourced resources.

From observarions and discussions at the Barangay level, households are yet
to fully appreciate the links between nutrition and food security. Highlight the
links between food security, specifically a balanced and nutritious diet and
child malnutrition. Utilise cooking classes to show how to prepare good
food, set up demonstration home gardens and follow up with plays or
interactive learning on nutrition and food safety and hygiene.

Expand livelihood opportunities such as the Cotabato City solid waste
management program. More diversity is also needed in income
generating activities, outside of traditional farming. Support businesses
such as milling and drying of crops would increase income opportunities in
the local economy.
WASH

After discussions with local communities and site visits of WASH facilities,
ACF should continue to encourage BAWASA leadership in maintaining
WASH facilities and include Water shed environmental management. This
is needed to protect the water source, reduce risk of contamination and
encourage all villages to fund maintenance activities. In some areas of
Kapatagan ownership of facilities and a system for collecting funds for
maintenance was not as effective.

Observations of WASH sites and discussions with BPMUs indicated a lack of
support from municipal government. ACF should advocate to Rural Health
Units and Local Governments to maintain water quality monitoring. The
regional sanitary inspector should ensure regular treatment and maintenance
of the water quality. Accountability of these local government positions is
currently poor, so a big push is needed from ACF and its partners to improve
this component of WASH.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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
Site visits revealed overall sanitation and hygiene practice is improving
however some areas in Kapatagan were still poor. Also, preliminary
findings from monitoring reports indicate there are still many households in
need with limited sanitation facilities and practicing poor behaviours in
hygiene. This will impact on household health and nutrition, especially
amongst children under five years old. ACF should reinforce sanitation
education and advocate for maintenance of toilet and latrines infrastructure.
Good Governance and Integration

Discussions with PMUs at various levels indicated a desire to be more
involved with the design, planning and monitoring of activities. These
activities should be co-led in partnership by user groups and institutions
(groups such as: BAWASA, Farmer groups, Municipal Government, and the
Department of Agriculture). This will increase ownership, provide on-the-job
training and improve the likelihood of a social services being provided in the
future.

After reviewing the program design and implementation of activities, ACF
should promote local institutions having key performance indicators to
track progress and hold them accountable. This would provide some concrete
benchmarks for local institutions to meet and provide incentives for better
performance. It would also provide specific goals and objectives that
communities can monitor and hold local government and agencies more
accountable. This is good practice that should be encouraged across local
institutions. Already some municipal government in Arakan are embracing
good governance with an award from the National Government being proudly
on display.

After discussions with municipal government and local partners, ACF needs
to lead by example on the integration process. Often different staff from ACF
were asking the same government representatives for the same information.
A common database for data and planning would assist the process of
sharing across the sector and reduce duplication.

After observations at BPMUs and local partners, capacity and skill
development should continue to be important strategy for program
implementation. Strengthening of community groups should be an
important focus and should include leadership, problem solving and decisionmaking skills in addition to the core technical capacities.

Reviewing the design and discussions with local leaders, ACF should
encourage greater community involvement by supporting a ‘People’s
Organisation’ to be a focal point to represent each village or cluster. This
group will contribute to the Barangay Development Plan (BDP) and
represent those without other representation in LGUs, BAWASAs or farming
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
43
groups. This will help include more vulnerable members of the community
including Indigenous groups.
Advocacy / Capacity Building

Observing interaction between the local community and government at the
three learning events in September, the evaluation recommends more is
needed to empower community to hold local institutions accountable. ACF
should support this ensuring communities know they rights and are engaged
in planning activities and feel connected with decision makers in government.
And, feel that they will listen to the community and debate development and
planning issues in the transparent manner.

After observing local partner approaches to delivering activities, ACF should
ensure education messages are more participatory. Utilising participatory
approaches that include river of life sharing techniques, simulations, pilot
demonstrations, community theatre and documentary film are effective
methods to deliver capacity building activities and messages.

Observing local partners and government agencies capacity, ACF should
provide opportunities for local partner and government staff to work inside
agency program office to increase experience and skills of locally engaged
practitioners. These mentoring opportunities will help build the confidence and
ability of local capacity to lead future programs.

Observations at local health centers reveal that health volunteers (BNS and
BHW) have struggled to receive their small allowance to cover travel. ACF
should advocate to local government to support this critical volunteer
system.


Monitoring and Evaluation

There are too many indicators (over 50). ACF should focus on measuring
what is the real indicator of success for their program. This can be
measured with (2-3) indicators for each sector, focusing on results-based
monitoring. As a result staff will reduce the time and resources spent
collecting data and focus more on managing core activities.

Provide a feedback mechanism for communities. Continue to keep open
communication with program staff and committee leadership. These
mechanisms add value to regular meetings with ACF facilitators.

In conclusion, ACF is technically and administratively well equipped to address the
dynamic challenge of reducing poverty in Mindanao. ACF has developed a sound
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
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44
integrated approach and will over the next two years refine and reshape some of its
implementation strategies outlined in this evaluation.
Measuring the success of this integrated approach will be demonstrated in
households combined vulnerability, specifically: does the household have reduced
risk of malnutrition, does the household have a diverse healthy diet and does the
household have access to clean drinking water and access to sanitation facilities.
Then, the program will need to analyze the speed and efficiency at which these
components were delivered together compared to a more component only driven
program. Furthermore, it will need to assess change in behaviour, knowledge and
practice by households in the key areas of nutrition and care practices, food security
and livelihoods and WASH to assess whether these areas are naturally linked and
adapted by communities.
The mid-term evaluation finds some overall good trends for this integrated approach
highlighted by reduced child malnutrition, improved knowledge and capacity of
farmers, access to water and improved hygiene. Throughout discussions in
communities, the evaluation observed some natural links starting to be made through
the key component of Nutrition, FSL and WASH. The evaluation also finds that with
the establishment of local PMUs, many of the same people are members on other
health/nutrition, farmer and water groups, therefore there is inherent sharing in
addition to informal sharing across these small communities.
So, Interventions must continue to utilise local community groups and provide a
participatory learning experience highlighting key success factors in overcoming
poverty and the natural links between nutrition, food security and WASH. For
nutrition, food security and livelihood interventions, ACF must rigorously assess each
context for vulnerability and market conditions, so that interventions can be truly
integrated and have a lasting impact. For long-term sustainability of this program,
ACF and its partners should support and advocate for communities to demand
accountability and better performance by local institutions and social service
providers.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
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5.0
DAC GUIDELINES
As part of the evaluation each component has been scored and summarized utilising
the DAC guidelines. Following this is an example of good practice, which could be
replicated across other programs and regions.

Criteria
1. Impact
(OUTCOME)
Rating
4
Rationale
 Established PMUs at provincial, municipal and village levels and MoUs
with key local government officials/agencies and local partner NGO,
INGO partners
 Recovery rate of SAM patient 56% in 2011, 71% in 2012 at OTP; and
88% at ITP
 Significant Water and Sanitation Access to communities and schools.
2. Sustainability
3.5




3. Coherence
4




4. Coverage
4



Functioning IMAM-IMCI at RHU level
Community participation in decision making processes
Initial cooperation with local government to delivery of basic servicies to
communities.
Multi-sectoral approach, including national (DOH, DoA) and
international (AECID, UNICEF) stakeholders.
Mainstreaming program components implementation within the existing
local government bodies.
ACF participated in the drafting of PIMAM development of Pocket
emergency tool for Nutrition in emergency and awaiting approval from
DOH and its implementation nationwide.
Implementing an integrated IMAM-IMCI within the local health
structures of RHUs and Barangay Health Stations.
Need to strengthen proactive dialogue with government partners.
Thorough assessment of remote and vulnerable areas.
More community participation to identify and prioritize the needy and
poor farmers in the target villages.
Families identified with malnourished children, particularly with SAM
families, should be inclusively given priority as beneficiaries on FSL and
WASH initiatives.
5. Relevance/
Importance
4

Most vulnerable population assisted and provided key services in
WASH, FSL and Nutrition. Malnourised children assisted.
6. Effectiveness
3.5

Delays in the implementation, however ACF is confident to complete
before mid-2014
Local health structures and community structures set and functioning.
Cross learning of experiences in North Cotabato and Lanao del Sur
areas should be institutionalized and part of MEL (monitoring,
evaluation and learning) process.
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7. Efficiency
4
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Nutrition screening and detection of malnourished children is a relevant
entry point in communities and integration of FSL and WASH.
Good software tracking for quantitative data in target areas.
Use more simple (participatory) monitoring to be adapted to local
government partners and communities for sustainability and learning.
Good technical mix of staff.
Sub-office in the program areas (in Lanao del Sur and North Cotabato)
near the target villages.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
46
6.0
GOOD PRACTICE IDENTIFIED FROM THE EVALUATION
Strengthening local structures through a community-based health system
approach to address acute malnutrition
Title of Best
Practice
Strengthening local structures through a community-based
health system approach to address acute malnutrition
ACF’s program has reduced malnutrition and is building a
stronger local health capacity. The following outlines the key
successes driving this integrated and community driven
initiative.
Innovative
Features & Key
Characteristics
Overall the ACF program had been successful in strengthening
the facility-based delivery/referral system, through health
centers at Municipal Rural Health Units and Barangay Health
Stations. It has mobilised community health structures that
are now a central component of the IMAM-IMCI integrated
approach towards better delivery in addressing child
malnutrition. It not only covers acute malnutrition, which is the
current focus of ACF’s work, but also for health center facilities
and communities to find solutions for all types of
malnutrition.
Success has been achieved through a combination of local
partnerships with organisations such as German Doctors, Don
Bosco, Maradeca and Montaner Hospital; and support of
health and nutrition volunteers who provide home visits and
key nutrition and care practice education to households. ACF
has contributed through deployment of nutrition and health
specialists who are providing core capacity building training
and currently transitioning skills and workload to local
practitioners. Furthermore ACF and its partners are providing
essential resources in the detection, prevention and treatment
of malnourished children.
Practical/Specific
Recommendations
for Roll Out
For local staffing, the program has focused on improving
the capacities of local health staff at health centers including
municipal health doctors, nurses, and midwives. Health
volunteers (BHW, BNS) have been provided training and
partnered with local communities in the formation of local
governance groups such as farmer groups, BAWASA and
informal community health committees.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
47
For its advocacy work, ACF is utilising case studies alongside
nutrition mapping data. Local government representatives such
as Mayors and Barangay leaders were very responsive and
took action when malnutrition levels in their municipalities and
villages were mapped, ranked and compared with other
regions. Moving forward ACF is advocating for continued
support from local authorities in providing doctors, nurses and
recruitment of sanitary inspectors. Improved conditions for
volunteer staff are needed to ensure continuation of home visits
to remote communities.
Continuing to support an effective and affordable local
community health care model alongside education are sound
step toward building local government support for a functioning
municipal health care system.
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
48
Annex 1 – Key Informants and Documents reviewed
Key informants
Organization/Village
BAWASA Committee and cluster
groups, Brgy. Proper Kapatagan,
Name/Description of Respondents who were Interviewed or participated in the
FGD
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Kapatagan Proper Elementary
School
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BAWASA Committee officers (chairman, vice-chairman, treasurer, Auditor,
Asst. Auditor)
Cluster Leaders
3 female, 8 male
RHM, Rural health midwife, Ruband Mascod (F)
RHU Nurse (F)
Municipal Health Officer (MHO) (M)
BNS, Zenaida Aleman (F)
BHW, Mariam Macatambeg (F)
Kagawad on Health, Kayangga Bansil (F)
Mother of SAM child undergoing treatment at OPT
Grandmother of SAM child who was treated at OPT
Randon home visit and interview with mother and father of 3 young
children with normal status (age 7, 10, 12 years)
Elementary principal (F)
Elementary grade school teacher/adviser (F)
A high school volunteer teacher (F)
FGD with grade 7 students (4 girls, 2 boys)
SitioTalbo, Brgy Proper
Kapatagan
BPMU level, Village Proper
Kapatagan
Municipal PMU level, Kapatagan

10 farmer cluster group members, Agri-inputs beneficiaries

BPMU members = 5-M, 5-F
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Municipal Mayor Maglangit (M)
SB Secretary Mama (M)
Vice-Mayor, Paisal Bansil (M)
Information Officer (M)
Secretary to the Mayor, Renato Calunod (M)
MPO, Bailanie de los Santos (F)
Assistant HR, LGU, Marites Dinodol (F)
LGU Representative = 6 M
Community Organizer, Junaima Tanog (F)
Community Organizer, Roxanne Pondiond (F)
Staff, Faridah Salic (F)
Administrative Officer, Safia Dumatingcal
Staff Nurse, Rene Bustillo (F)
FSL Head of Program, Rolando Albino (M)
FSL Technical supervisor, Surafa Ebus (M)
WASH Head of Program, Regina Paypa (F)
WASH Engineer, Anwar Mokamad (M)
Hygiene Promotion Officer, Marigold Feniza (F)
Nutrition Head of Program, Oscar Fudalan (M)
Nutritionist, Pete John Biscara (M)
Nutritionist, Zahara Kamid (F)
Head of Base, Javad Amoozegar
M&E Officer, John Tamayo (M)
Liaison Officer, Rosa May Maitem
Country Director, Eric Fort (M)
Technical Coordinator, Suresh Murugesh (M)
Nutrition Coordiator, Martin Pareno (M)
Advocacy Officer, Kristine Calleja (F)
WASH Coordinator, Rasul Abdullah (M)
FSL Coordinator, Damos Militante (M)
Village Daguan reprepresentatives = 5-M, 2-F
Village Bongabong representatives = 2-M, 1-F
Village representatives = 4 M
MARADECA = 1 F
LGU Kapatagan representatives = 1-F, 1-M
ABC Chairman = 1 M
ACF Staff = 3-M, 3-F
Kapatagan RHU
Individual Interviews, Village
Proper Kapatagan
MARADECA, Inc Staff
Montaner Hospital
ACF Staff, Cotabato Base
ACF, Makati Base
Feedback & Learning Workshop,
Kapatagan
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Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
49
Village Mother Bagua, Cotabato
City
Office of the Mayor, Cotabato City
Farmer Group, Tumanding Arakan
BAWAS (Water Committee)
Tumanding Arakan
Health Key Informant Interviews
Tumanding Arakan
BPMU Tumanding Arakan
Farmer Group, President Roxas
Datu Sundungan
BAWASA, President Roxas Datu
Sundungan
Health Key Informant Interviews
President Roxas Datu Sundungan
Municipal PMU Arakan Población
Municipal PMU President
RoxasPoblación
Provincial CTF Kidapawan (Amas)
German Doctors Kidapawan
(Amas)
Don Bosco, Kidapawan (Amas)
Learning Workshop Arakan
Población
Learning Workshop President
Roxas Población
AECID
Department of Health, HEMS
UNICEF
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Village Council member, Community Service (F)
Village Council member, Finance (F)
Village Council Secretary (M)
Municipal Mayor (M)
Secretary to the City Mayor (M)
Ma. Rita Baraguin, PEO IV (F)
Ronnie Cadorna (M)
Oscar Rendon PO IV (M)
Porfirio de los Santos, PO IV (M)
Farmers and Household Members 13 (M-8) (F-5) including
Chairman, 4 x Board of Directors, 4 x Tap Stand Leaders
BAWASA Members x 12 (6 F, 6M) inlcuding;
Vice Chiarman,
2 Team Leaders.
Members x 5 (5 F) inlcuding;
BNS,
BHW x3,
RHM
Members x 20 (12M, 8F) inlcuding;
Chairperson,
Secretary,
Famers x 4,
Health Workers x4,
BAWASA member x 4
Members x 15 (5M, 10F) including;
BLGU Secretary,
FSL Member x 3
Members x 13 (7M, 6F) including;
Chairman,
Secretary,
Board of Directors x 4,
3 x Team leaders
Members x 14 (F) including;
Mid-Wife,
BHW x 9,
BNS,
BHS
Members x 13 (9M, 4F) inlcuding;
President MayorLGU,
Barangay Captain x 2,
MoH,
DoA
Members x 10 (5M, 5F) inlcuding;
ABC President,
Nutritionist,
Mid-Wife,
Barangay Captain x2
11 Members including;
Deputy Director,
Nurse x 2,
Provincial Health Officer and Nutritionist
Doctor, Darel Quisil (F)
Nutrition Nurse, Mia Gerigdig (F)
Ward Nurse, Mariecris Jarales (F)
Members x 7 inlcuding
Community Faciltator x 5
Partner Liason Officer
Executive Secretary / Administrative Officer
Members x 40 representatives from previous meetings and FGDs

Members x 26 representatives from previous meetings and FGDs
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Governance Advisor and Development Officer,
Technical Staff on Nutrition, Florinda Panlilio
Nutrition Specialist, Health & Nutrition Section, Henry Mdebwe (M)
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
50
Documents Reviewed
Description
Document Title
Program Plans/Reports
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Annual Plan 2, year 2011
Annual Plan 3, Year 2012
PAC 1 Plan Report, Aug- Dec 2010
Annual Monitoring Report, PAC 2, Jan-Dec 2011
Activity Progress Report (FSL, WASH, NUT), July 2012
Convenio 1st Internal Monitoring Report, 2nd Quarter 2012
ACF Program Proposal, Central Mindanao, 2010-2014
Program Planning Matrix

Household Economic Assessment, Arakan & Pres. Roxas municipalities
of North Cotabato and Kapatagan of Lanao del Sur, Dec 2010
Anthropometric Nutrition and Mortality Surveys, Arakan and President
Roxas, North Cotabato, Region XII, Kapatagan, Lanao Del Sur, ARRM,
October-December 2010
Knowledge, Attitudes, Practices (KAP) Survey, Arakan and President
Roxas, North Cotabato, Region XII, Kapatagan, Lanao Del Sur, ARRM,
November 2010
Market Study of Poor Producers in Central Mindanao and ARMM, June
2011
Program Assessments/Surveys
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Partnership Contracts/Agreements
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Partnership Contract, Don Bosco Foundation
Partnership Contract, German Doctors
Partnership Contract, Maranao People’s Development Center
(MARADECA)
Partnership Contract, Montaner Hospital
Memorandum of Agreement, ACF- DOH ARMM
Memorandum of Agreement, ACF- DOH Region XII
Memorandum of Agreement, ACF- LGU Kapatagan
Memorandum of Agreement, Provincial LGU, Lanao Del Sur
Memorandum of Agreement, LGU Arakan
Memorandum of Agreement, Midsayap Mun, North Cotabato
Memorandum of Agreement, Provincial LGU, North Cotabato
Memorandum of Agreement, LGU President Roxas
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List of Target Villages and Intervention Areas
ACF Cotabato Briefing Presentation
Integration Matrix of Activities for PHJGAA, Sep 06, 2011
ACF Cotabato Base Organogram, Sep 2012
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ACF Learning Review 2011
Comprehensive Development Plan (CDP), 2011-2013, Kapatagan
2011 FNRI Nutrition Data
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Guidelines for management of Severe Acute Malnutrition, In and Out
patient treatment, ACF, January 2010
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Capitalization Report, Solid Waste Management Program, Cotabato City,
August 2010
Other Program-Related Docs
Others
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
51
Annex 2 – Sample of Most Significant Stories
(From contributions received from communities in the ACF’s program)
1. ‘Sufficient Knowledge on Nutrition Towards a Peaceful Community’
(sic) There are many malnutrition cases in our area. We do lack the capacity to address and
manage it so we are happy with the arrival of this Convenio Program. It has changed a lot of
things among the community and within RHU. One of those is the awareness of the
community on the importance of nutrition. As a Municipal Health Officer, I have seen fewer
cases of malnutrition and fewer cases of diseases.
Dr. Ashar Dimapanat, Municipal Health Officer (for almost 6 years), Rural Health Unit,
Kapatagan, Lanao del Sur
2. Change in the nature of BHW participation in development activities.
(sic) Part of my role as a BHW to motivate our community for the process of behaviour
change and that education is one of the finest ways. Now, I am able to conduct hygiene
promotion sessions and I am also helping in Promotion of Good Nutrition (PGN). A
breakthrough for me was the seminar on Home Water Treatment and Storage (HWTS) with
Practicum on Water Analysis. All of the BHWs including our BNS participated with this. Now
we go to the tap stand and get a water sample and get samples from the households to test.
We did the actual water analysis and found our water was clean but when it reaches our
house it was contaminated. We took this to our community then made a plan to fix with money
collected.
Dhalia Buned Local Health Volunteer, Barangay Datu Sundungan, Pres. Roxas
3. ‘Building good farming relationship’
(sic) I received an agrikit3A (corn, farm tools, mungbean and seven types of vegetable
seeds). I am an enthusiast in volunteerism and a community volunteer. I am happy what I
learned in terms of practical technology for poor farmers and I am willing to share my
knowledge to other farmers. I now have more Indigenous friends now and happy that I can
help them in a very little way. I recommend that learning site are located a more accessible
location to increase participation of lactating and old people.
Leny Oyao , household farmer Centro, Ganatan, Arakan, North Cotabato
4. ‘Leaving Behind the Road of Malnutrition’
(sic) My son was a child who was identified with SAM when ACF conducted a survey in
Kapatagan. He was thin and sickly then. Now he has improved to a healthy weight and active.
I’m happy because I thought my son had no hope of becoming healthy. I thought malnutrition
was not a disease. It was in fact a life-threatening disease if it was not immediately attended
to. Now, I ensure my children have nutritious food so the disease would not recur. If they feel
something unusual I immediately bring them to the Health Center. My knowledge has been
enriched especially in the proper care of my children and how to be healthy and how my
family avoid being sick.
Aileen Kasan, mother of the first SAM child identified in Barangay Daguan, Kapatagan
Mid-term Evaluation ‘Support for the socio-economic development of the communities within the Spanish
Development Cooperation’s action zones in the Philippines Program’ Oct 2012.
52