Considerations for programme monitoring and evaluation

Including a strategy for monitoring and evaluation of a nutrition–related multi–sectoral response in emergencies is essential to:

• track progress and assess achievement of aims and objectives
• assess programme performance in terms of effectiveness and efficiency
• identify challenges and potential solutions and provide feedback to the government and other partners involved.

General requirements include the need for:

• Common objectives across sectors for nutrition, ie, agree what success looks like.
• Common results framework across programme/sectors that includes a timeframe.
• Building on what is already being measured and used at country level (eg, multisectoral country plans).
• Indicators (both output and outcome) that monitor the different steps of the pathway (ie, monitoring a broader set of lower–level indicators) to preventing undernutrition in context and that can be directly attributed to the intervention(s) implemented. This can provide evidence that the programme at minimum partly contributes to the full pathway. This is important because it may be challenging to capture programme effects on higher–level nutrition status outcomes such as wasting, stunting, MNDs, LBW etc. A change in these indicators may follow a long pathway and occur outside of the programme timeframe, and/or there may be numerous factors that contribute to change with the effect size of an intervention varying depending on context.³¹ It can also be challenging to measure these indicators in population level surveys that align with the timeframe of response.

Whilst ultimately the aim of any multisectoral response to prevent undernutrition would be no/limited escalation in wasting, stunting and MNDs, for the reasons discussed above, monitoring data should aim to track indicators along defined pathways to undernutrition. If a programme impact evaluation is planned, then there is potential for the contribution of the programme/ response in terms of longer–term impact (eg, on prevalence of wasting/stunting, disease incidence, anaemia prevalence, VAD deficiency prevalence etc) to be inferred.

The table below presents some examples of monitoring information that can be collected from each of the sectors and interventions presented in the response options framework in Figure 3. It draws on recommendations for monitoring and evaluation in existing technical guidance for the range of interventions listed as well as that provided by guidance on multisectoral response such as the inter-cluster / sector collaboration (ICSC) approach. Programmes should complement these standard indicators according to what is already being collected in-country and with more contextually–specific process indicators to reflect planned activities and targets.

Action Against Hunger (2017) WASH’Nutrition: A practical  guidebook on increasing nutritional impact through integration of WASH and Nutrition programmes. London, UK: AAH.

FAO (2013) Guidelines for measuring household and individual dietary diversity. Rome: FAO.

FAO (2021) Minimum dietary diversity for women. Rome: FAO. 

FAO (2023) Technical guidance to improve nutrition through cash-based interventions |Policy Support and Governance| Food and Agriculture Organization of the United Nations. 

Food Security Cluster et al. (2023) Monitoring and Evaluation of Multi-Cluster / Sector activities in countries Guidance note. UN ICCG. 

IFE Core Group (2017) Operational Guidance on Infant Feeding in Emergencies (OG-IFE) version 3.0. Emergency Nutrition Network (ENN). (Accessed: 29 February 2024).

MQSUN (2020) MQSUN+ Toolkit on Multisectoral Planning for Nutrition – MQSUN+. (Accessed: 27 February 2024).

SQ-LNS Task Force (2024) From Theory to Practice: Operational Considerations for Incorporating Small-Quantity Lipid-Based Nutrient Supplements into Programs to Prevent Undernutrition Among Children 6–23 Months of Age. Davis, CA: SQ-LNS Task Force.

Technical Assistance for Strengthening Capabilities (TASC) (2022) Monitoring and Evaluation of Nutrition-Relevant Programmes. A guidance note. London, UK: DAI for FCDO.

UNHCR and Save the Children (2018) Infant and Young Child Feeding in Refugee Situations: A Multi-Sectoral Framework for Action. Geneva. (Accessed: 25 June 2024).

UNICEF (2020) Evidence and Guidance Note on the Use of Cash and Voucher Assistance for Nutrition Outcomes in Emergencies | Global Nutrition Cluster. New York. (Accessed: 13 April 2023).

UNICEF (2022) Maternal Nutrition. Prevention of malnutrition in women before and during pregnancy and while breastfeeding. New York.

UNICEF (2023) Integrating social protection and nutrition | UNICEF Eastern and Southern Africa. UNICEF. (Accessed: 20 October 2023).

UNICEF (2024) Programme Guidance to Protect the Nutrition of Women and Adolescent Girls in Humanitarian Settings. New York: UNICEF. (Accessed: 6 September 2024).

WFP (2023) Livelihood Coping Strategies Indicator for Food Security Guidance Note. Rome: WFP. 

WFP (2024) Food Consumption Score & Food Consumption  Score Nutritional  Analysis   Guidance Note. Rome: WFP.

WHO and UNICEF (2021) Indicators for assessing infant and young child feeding practices.  Definitions and measurement methods. Geneva: WHO & UNICEF. 

World Health Organization (2017) Global nutrition monitoring framework: operational guidance for tracking progress in meeting targets for 2025. Geneva: WHO & UNICEF. (Accessed: 15 August 2025).

Yiru Xu, Y. et al. (2021) ‘Integrating nutrition into the education sector in low- and middle-income countries: A framework for a win-win collaboration’, Maternal & Child Nutrition, 18(2). 

³¹ “If a programme does not lead to a reduction in direct nutrition outcomes such as stunting and wasting, this does not mean it has been a failure and “should not be interpreted as a lack of benefits or a reason to discourage investment in nutrition”. Monitoring nutrition outcomes that fall outside the timeframe of your programme may reflect negatively on that programme, even though it actually may have been (or may yet be) successful.” (Monitoring and Evaluation of Nutrition-Relevant Programmes A guidance note, TASC Project, May 2022