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Haiti[1998–Present] Since 1998, FANTA has provided technical assistance on nutrition and food security to USAID/Haiti and Title II Awardees, which work in sectors such as maternal and child health and nutrition (MCHN), water and sanitation, agriculture, and natural resource management. FANTA develops strategies, guidelines, training, tools and research, as well as resources for program monitoring, evaluation and assessment. At the Mission’s request, the project also helps address the nutrition needs of people living with HIV (PLHIV). FANTA’s recent work includes developing guidelines on the nutrition care and support for PLHIV and helping Title II Awardees better forecast and respond to food security crises. Preventive Approach to Reducing Malnutrition: FANTA produced the Title II Technical Reference Material (TRM) TRM-01: Preventing Malnutrition in Children Under 2 Approach (PM2A): A Food Assisted Approach to help Title II Awardees adopt PM2A, which is now the USAID Bureau for Democrac, Conflict, and Humanitarian Assistance Office of Food for Peace (DCHA/FFP)’s recommended approach for food-assisted MCHN programs. The publication drew from a five-year study in Haiti by FANTA, the International Food Policy Research Institute (IFPRI), Cornell University and World Vision that found that using the preventive approach in nutrition interventions reduced population malnutrition more effectively than using the recuperative approach. The study, Age-based preventive targeting of food assistance and behavior change and communication for reduction of childhood undernutrition in Haiti: a cluster randomized trial, was published in the January 2008 issue of The Lancet. Early Warning and Response (EWR): Building on a system that CARE developed in northwest Haiti and FANTA helped expand to other parts of the country, FANTA helps Title II Awardees improve their EWR to food security crises. FANTA also works with USAID to implement “surge capacity,” the rapid allocation of resources to Title II programs to keep food security from worsening during an emergency. Nutrition Care and Support for PLHIV: FANTA developed National Guidelines on Nutrition Care and Support for PLHIV and nutrition counseling materials for PLHIV (available in French and in Haitian Creole). The guidelines and counseling materials were completed during joint workshops with the Ministry of Public Health and Population’s Groupe de Travail Technique de la Nutrition (Nutrition Technical Working Group). Program Monitoring, Evaluation and Assessment: FANTA helped the Mission and its Title II partners harmonize their monitoring and evaluation (M&E) indicators by examining discrepancies among the different M&E systems and working to build in greater convergence. At the request of USAID/Haiti, FANTA helped Title II Awardees conduct a joint baseline survey, including by designing the sampling approach, programming data collection software, and developing training and survey materials. Layers: The Layers monitoring system for Title II programming was originally developed in Haiti. It is now a mature system, sustainably and autonomously maintained by USAID/Haiti. Results from Layers survey rounds are now routinely used by the Mission to verify the quality of programs in the field and to develop recommendations to ensure that food assistance is being delivered with maximum effect to the intended populations. Nutrition and Food Security: FANTA has been providing technical support to the USAID Title II Cooperating Sponsors to strengthen the implementation of their Title II development programs and to the USAID Mission in areas related to nutrition and food security. USAID/Haiti has also requested FANTA technical assistance to address the food and nutrition needs of people living with HIV (PLHIV), including ART clients, pregnant and lactating women, and orphans and vulnerable children (OVC) in Haiti. In 2011, FANTA completed a food security assessment, Haiti Prospective Food Security Assessment, to describe and analyze current and anticipated near-term food security trends in the country and the events, policies, and strategies shaping them to inform USAID planning and guidance development for FY 2012 Title II development food aid programs. The data and information in this report, including areas particularly vulnerable to food insecurity, are also meant to assist potential future Title II Awardees in designing the next round of development food aid program proposals in the country. USAID staff in Haiti and Washington, DC, and international and nongovernmental organizations, donors, and Government of Haiti (GOH) colleagues working on food security in Haiti may also find this report useful. Preventive Vs. Recuperative Approaches in Food-Assisted Nutrition Programs: With partners the International Food Policy Research Institute (IFPRI), Cornell University and World Vision, FANTA completed a five-year study in Haiti comparing preventive and recuperative approaches in nutrition interventions. A key finding was that the preventive approach was more effective in reducing population malnutrition levels than the recuperative approach. These findings provide the first evidence of the relative effectiveness of a preventive approach compared to a recuperative one. The results of the study, Age-based preventive targeting of food assistance and behavior change and communication for reduction of childhood undernutrition in Haiti: a cluster randomized trial, were published in the January 2008 issue of The Lancet. Harmonization of Indicators: Considerable progress has been made over the years to harmonize monitoring and evaluation (M&E) indicators used by USAID/Haiti and its Title II partners. FANTA expanded this work to include M&E indicators used by Management Sciences for Health, USAID/Haiti's bilateral contractor in health. FANTA conducted a number of workshops and provided other technical assistance to examine discrepancies among the different M&E systems in order to build in greater convergence. Early Warning System: Thanks to the efforts of CARE and its local partners, a simple but effective early warning system was developed in the northwest region of Haiti under their current Title II development assistance program. With support from FANTA, the CARE model was expanded and adapted to the other three CSs operating in the country, providing the first large-scale integrated early warning system in Haiti. This initial effort was later joined by FEWS NET under the umbrella of the Conseil National de Sécurité Alimentaire, the Government of Haiti's office in charge of food security and early warning. FANTA continues to provide technical assistance and support to the development of an early warning system in Haiti. 
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