Designing for Community Resilience in Chad
There is much interest in creating systems to build resilience at the community level. Unfortunately rigorous data on the best intervention packages is scarce. To address the evidence gap, Concern is partnering with the Feinstein International Center at Tufts University to rigorously evaluate its Community Resilience to Acute Malnutrition program in eastern Chad and generate evidence to contribute to international discussions on the concept of resilience.
Based on knowledge gained from other programs, in early 2012, Concern designed a three-year program involving water, nutrition, disaster risk reduction, livelihoods, and inequality interventions. The program was developed to improve the overall health, nutrition, and livelihood security of the rural population of Dar Sila in eastern Chad while improving their resilience to shocks.
Between 2005 and 2010, many people in the Dar Sila region were displaced due to conflict on both sides of the Chad-Sudan border. While insecurity has decreased, the region remains vulnerable to food insecurity for many reasons, including unpredictable rainfall patterns, market price hikes, limited community and household assets, and limited alternative livelihood options. The population is susceptible to shocks, having experienced poor harvests in 2009, pockets of flooding in 2010, and significantly below-average harvests again in 2011, due in part to pest attacks and erratic rainfall. These events have depleted stocks and led to food shortages, leaving households vulnerable to future disasters.
Taking an integrated approach, Concern aims to deliver a range of projects addressing multiple needs, coordinating across sectors to achieve common goals. Success will be measured in terms of household wealth via proxies such as livestock ownership and household assets. In turn, greater wealth is expected to lead to increased dietary diversity, less reliance on negative coping strategies, and increased food security. Improvements in health and nutrition will be measured through improved practices related to child health and behavior, while improvements in water and sanitation will be measured through increased access to potable water and latrines. The impact of the program will be reflected in improvements in the nutritional status of children and maternal health.
The first part of the program aims to provide an integrated package to build long-term community resilience. It focuses on four key intervention areas (Figure 4.2) with social and behavior change as a critical ingredient of all four. Resilience-building components of the program include the following:
- Improving agricultural production and diversifying livelihoods and assets (promoting conservation agriculture and homestead gardening, improving soil fertility, supporting extension and community animal health workers, and promoting links between farmers and markets).
- Improving access to health services through community health outreach, community case management and care groups, effective management of moderate acute malnutrition, and stronger management of the formal health system.
- Increasing access to safe water and promoting improved sanitation and sanitary practices at the community level.
- Working with community groups at all levels, including establishing overall apex bodies such as Village Development Committees for better governance, to enhance their capacities and to ensure that women participate fully. This will involve working closely with community leaders and trying to change their attitudes and behaviors. One output will be a disaster management plan.
- Promoting social and behavior change among those Concern works with, across all parts of the program. This includes changing child feeding practices, encouraging better hand-washing techniques, and changing how farmers plant their crops using conservation agriculture techniques.
The second part of the program includes a comprehensive community-based early warning system that identifies thresholds for key indicators that signal the need for an emergency response. In the first instance, the community will activate its own disaster management plans. After that, the program will initiate a response, strengthening capacities for conducting market analysis and nutrition surveys, getting systems in place to scale up cash aid, creating a system for immediate distribution of emergency supplies, creating village maps that identify the most vulnerable to shock, and formulating a strategy to scale up staff capacity. The early warning system links primary data from the household level and local and regional markets with rainfall and vegetation data from the Famine Early Warning Systems Network, a provider of information on food security. Data will include the Rainfall Estimation and Normalized Difference Vegetation Index (FEWS NET 2013), which is updated every 10 days. Existing health facility data, such as case incidence and admission rates, will also be used.
Primary data will be collected on key food crop prices from a selection of markets and from a Coping Strategies Index that will be calculated on the basis of a sample of households. This will be based on four kinds of locally relevant coping strategies (Maxwell and Caldwell 2008): (1) dietary change; (2) short-term measures to increase household food availability; (3) short-term measures, such as fostering arrangements or sending children to relatives, to decrease the number of people a household must feed; and (4) rationing, or managing the shortfall.
This program will be implemented in 53 of the 88 villages of Kimiti. Thirty-five of these will receive the same package of services and will be rigorously monitored to test the success of the program. Eighteen will receive various elements of the program, in some instances as part of a pilot for new interventions. The remaining 35 villages will receive the benefits of the strengthened government health system in the area and will be included in the early warning system. They will also be surveyed to demonstrate that the intervention has worked. If these villages pass the emergency response threshold, Concern will intervene.
When early warning indicator values, which include rainfall and vegetation measures, exceed a threshold level, an emergency response is triggered. The goal of Concern’s resilience-building package is to minimize the impact of the shock by reducing the number of hunger days, reducing the number of people with global acute malnutrition, and speeding up recovery time. The provision of an integrated package should have a positive impact on child and maternal nutrition in a “normal” year but also in those years when the region experiences comprehensive weather-related shocks. This happens about once every three years.
Figure 4.3 shows the expected impact of this program. The red line represents the values for one of Concern’s early warning indicators in a normal year. This indicator fluctuates on a seasonal basis and may come close to the intervention threshold, represented by the dashed line. Once this threshold is exceeded (probably about once every three years), an emergency intervention is considered. The value of the indicator may spike in the control area (orange line), but Concern’s resilience-building package should reduce the magnitude and duration of the spike in the treatment area (green line).