Link NCA – A Nutrition Causal

Analysis

Marie SARDIER (ACF), Link NCA Project

Coordinator

CORE Group

March 2nd 2016

• What is a Link NCA? Why we developed a new method?

• Research questions, objectives and key steps

• What the methodology IS NOT

• Crucial points to keep in mind

• Key results and added-value of Link NCA study

• When can a Link NCA study be relevant?

• Available tools and documents

• New contexts – upcoming technical development

AGENDA

What is a Link

NCA?

Why we

developed a new

method?

• STRUCTURED: for a more efficient process and to

ensure quality and usability of results

• LOCAL: for programs which are adapted to

communities, livelihood zones, homogenous areas

• OPERATIONNALLY REALISTIC: to balance scientific

rigor and field realities (resources et expertise).

A need for a methodology that

is:

• A mixed-methods, participative, holistic study

• Based on UNICEF’s Conceptual Framework

• Objective: to build a consensus

• Based on evidence

• About possible causes of under-nutrition

(Acute or Chronic) and mechanisms

• In a local, homogenous context

What is a Link NCA (2010 …):

Research

Questions

&

Key steps of a

Link NCA

Qualitative

Study SMART

Risk

Factor

Survey

1.

Malnutrition

prevalence

2. Risk-factors

prevalence

3. Nuanced and

detailed description of

pathways

4. shocks, seasonality

and historical trends

5. Risk factors and

main pathways

Research questions and Objectives

6. R

ec

om

me

nd

ati

on

s t

o im

pro

ve

nu

trit

ion

se

cu

rity

pro

gra

mm

ing

Preparatory Phase / ≈ 1 month

Identify potential risk factors and pathways / 4-6 weeks

Data collection / 7-8 weeks

Data analysis and construction of a consensus / 6-8 weeks

Communication of results and response planning / 3 weeks

4,5-5 months

Key Steps

What tools to be used at each step

Preparatory Phase

Gather literature on local context (grey

lit/reports, and academic literature)

Decide if Link NCA is necessary / relevant

Define « homogeneous » zone

Identify potential risk

factors and pathways

Analysis of literature on local context

KI interviews

Module « Pathways of Undernutrition »

Data collection Quantitative: (cross-sectionnal survey / cluster sampling) Survey : Indicators’ Guide + SMART Qualitative: in 4 communities

What the

methodology

IS NOT

• It is not a rapid, “quick win” methodology

• Most of its results cannot be generalized,

they are specific to a homogenous context

• It is not a tool for emergency needs

assessments

• Supposed to be valid for a while – until

major changes / evolution have happened

Crucial Points

• Complementarity of qualitative and quantitative

methods with strong qualitative component

• Skills of “Analyst” are crucial – importance of

good recruitment

• Decisive importance of preparatory phase

(gather information – think “out of the box”)

• Take a step back from our own technical fields

Key Results of a

Link NCA

• Under-nutrition prevalence

• Key risk factors prevalence

• Better understanding of communities’ own perceptions

and knowledge about under-nutrition – hear the voice

of affected populations

• Under-nutrition pathways and associated risk factors,

in all their complexity

• Description of groups vulnerable to under-nutrition,

affected populations

• Description of local mechanisms which lead to under-

nutrition and their interconnections

• Local causal model of under-nutrition

• New, or detailed and

nuanced understanding of

pathways, mechanisms

• Advocacy tool

• Improve programming

Added-value

Deconstruct preconceived ideas

on causes of under-nutrition

Ex:

Burkina Faso (saisonnalité / hunger gap)

Ex:

Bangladesh (low birth weight)

Dig into the complexity and

interconnections of risk factors

Ex:

Philippines (Antiparasitaire)

Revise operational priorities

Strengthen community voice

Ex:

Burkina (birth spacing)

Improve nutrition-sensitive

programming and advocacy

Ex:

Kenya – West Pokot

When is a Link

NCA relevant?

Limited information of

vulnerable zone.

A few interventions may be in

place. Ministry of health’s agenda

is to reduce prevalence of under-

nutrition.

A crisis emerged rapidly (rapid-

onset), the population is in a

critical situation, and a rapid

increase in under-nutrition cases is

expected

(not what the methodology was 1st devised for – but recent requests…)

Many and varied interventions on

underlying causes of under-

nutrition in place for the past 5 / 10

… years; but prevalence has not

diminished.

Tools and

Resources

Tools and Resources

OVERVIEW

GUIDELINES

TOOL BOX

INDICATOR

GUIDE

PATHWAYS

MODULE

TRAINING

KITS

www.linknca.org

Pathways Module

Indicators Guide

Bangladesh Burkina Faso Ethiopie Inde Kenya Pakistan Philippines RDC Sud Soudan Tchad Zimbabwe (Yemen

3 1 2 1 2 1 1 1 1 1 1 1

ACF-F ACF-F ACF-F ACF-F

ACF-US ACF-US ACF-Sp ACF-US ACF-US

ACF-F ACF-F

ACF-F) Afghanistan

Tchad Ethiopie Cambodge Kenya Mauritanie Côte d’Ivoire Ouganda RCA

1 1 2 1 1 1 3 1 1

ACF-F IMC

ACF-F ACF-US

Concern ACF-US

ACF-F/PNN ACF-US

Croix Rouge-F

2010-2015

2015-2016

DONORS

ACF OCHA

OFDA SIDA

ECHO UNHCR/WFP

DFATD AFD

UNICEF

• Urban Contexts

Abidjan (PNN, ACF)?; Nairobi

(Concern)?

• Camps / Displacement situations

Bentiu PoC (Cluster, Concern)? Dollo

Ado (WFP, HCR)? Gambella (HCR)?

• Improve Indicators’ Guide and

Pathways module

Upcoming Technical Development

• Site Internet:

• http://linknca.org

• Technical Support – Link NCA – Blanche Mattern

• bmattern@actioncontrelafaim.org

• Project Coordinator – Marie Sardier

• msardier@actioncontrelafaim.org