Objective:
This evaluation assessed the implementation of 18 nutrition interventions delivered by four ministries of the South African Government — Health, Social Development, Agriculture, and Rural Development – and sought to determine the enabling and inhibiting factors for implementation.
Approach:
Khulisa used a qualitative case study approach to: understand the Government’s underlying program theories around its nutrition interventions; evaluate the effectiveness of project implementation; identify barriers to effective delivery; and gauge fidelity to relevant policies. The evaluation examined critical system and implementation issues that inhibit or enable access to nutrition interventions for pregnant women and child under the age of five.
Data collection methods included a literature review; in-depth interviews; focus group discussions with key respondents at national, provincial, district, and site levels; and a rapid performance assessment administered at health facilities and community nutrition programmes.
Through both the literature review and fieldwork in four provinces of South Africa – KwaZulu-Natal, Western Cape, Free State, and Eastern Cape – Khulisa broadly examined the implementation of the 18 nutrition interventions. We undertook in-depth analyses for eight case studies: four provincial case studies and four case studies on the following priority interventions:
- Breastfeeding support;
- Targeted meal supplementation (delivered through health facilities); and
- Food access (food parcels, food banks, and food kitchens delivered by the Department of Social Development), and household food production and preservation (home gardening).
Impact:
The results of this evaluation had a direct policy impact. South Africa’s National Food and Nutrition Security Plan (2018 to 2023), a comprehensive and integrated national plan, specifically mentions the findings from Khulisa’s evaluation and attributes the development of the national plan to the evaluation’s findings.