Senegal


                    SENEGAL – Leveraging a National Nutrition Program
     The Nutrition Enhancement Program introduced cash transfers to address a crisis

The Nutrition Enhancement Program in Senegal introduced cash transfers as part of a response to the
food price crisis, building on a well-established community-centered nutrition program that leverages
broad participation to deliver training, micronutrients and asset transfers.

The Situation in Senegal:
At the start of the new millennium, malnutrition in Senegal was a major concern. Nearly one in every
three children under five years were stunted, one in ten were wasted, and two in ten were underweight.
Rates varied by geography and by income, with the poor and rural, and residents of the north, south and
central zones, suffering more than others.

The Program:
In 2002, Senegal launched the community-based Nutrition Enhancement program. It targets children
under five as well as pregnant and lactating women, providing benefits to 70 percent of the country’s
population. In 2009, the program incorporated a child-focused social transfer to help vulnerable families
cope with the sudden loss of purchasing power brought about by the global food price crisis.

The community nutrition aspect integrates growth promotion and management of childhood illnesses,
supports a network of caregivers and community agents—including grandmothers, in-laws, and men—
with SBCC training, and promotes the management of acute malnutrition at the community level. It also
includes food security initiatives (small-scale livestock, gardens, grain banks) and provision of
micronutrients.

The social transfer aspect provides an unconditional cash transfer to participating mothers. The cash is
expected to support the purchase of nutritious foods and other services that promote the development
of children. It is accompanied by SBCC activities that emphasize maternal and child nutrition, as well as a
close monitoring program to track both process and impact. Community-level organizations and local
government work in partnership to identify vulnerable households that should receive the cash transfer.

Implementation Lessons:
The program was evaluated as part of an overall assessment of Bank’s support to nutrition in the country,
“Senegal: A Decade of World Bank Support to Senegal’s Nutrition Program�. The evaluation highlighted
three main aspects that contributed to the program’s success:

• Well-designed service delivery. The program centered its delivery on community services. By
  operating at the local level, interventions were flexible and adjusted to the needs of the target groups.
  The program included accountability mechanisms to address the roles and responsibilities of different
  actors.
• Multisectoral and decentralized implementation. In addition to the Health and Education sectors,
  local governments were key in supporting the financing, coordination, and implementation of the
  program. They were also pivotal in involving other actors such as agriculture, livestock and local
  projects.
 Senegal


 • Targeting the right groups to deliver behavior change. Communication efforts were tailored to the
   cultural values of the targeted population. The involvement of religious, traditional, and cultural
   leaders—as well as other people with influence on mothers’ behaviors—helped mobilize the
   population to attend group discussions and to encourage changes in behaviors.
• Framing a cash transfer for nutrition. A separate impact evaluation showed that cash transfers can
   facilitate access to more nutritious food and other critical investments needed in the early years. The
   accompanying communications campaign is essential to ensure transparency of the cash transfer
   scheme as well actual changes in behaviors.

 Outcome indicators from this evaluation showed the following results associated with the development
 of children in the early years: 91 percent of children participating in growth promotion sessions, and 81
 percent attending monthly weighing sessions showing adequate weight gain.

 Resources & References Implementation:
     •     Independent Evaluation Group (IEG)/World Bank (2016). A decade of World Bank Support to
           Senegal’s Nutrition Program. Project Performance Assessment Report.