1. Community Resilience to Acute Malnutrition (CRAM) Kate Culver Nutrition Advisor

2. Resilience - definition Concern understands resilience as the ability of a country, community or household to anticipate, respond to, cope with, and recover from the effects of shocks, and to adapt to stresses in a timely and effective manner, without compromising their long- term prospects of moving out of poverty.

3. Background Area GAMSAM 2010 201120102011 Marsabit1.3%5% Wajir North1.4%6.8% Moyale3%1.5%

4. Social and Behaviour Change Access to safe and sustainable water services and sanitation facilities and improved hygiene practices Strengthened community organisations and the increased participation of women Access to and use of high quality health and nutrition services Improved agricultural production and diversification of livelihoods for the extreme poor Community Resilience to Acute Malnutrition (CRAM)

5. Emergency Response Improved health, nutrition and livelihood security for rural population as well as improved resilience to shocks Package to build community resilience Early warning system If threshold is passed In normal years with no shocks In all years Effective emergency response means outcome indicators still achieved

6. Community Resilience to Acute Malnutrition (CRAM)

7. Existing Livelihood Options Availability of Land Religion/ Ethnicity Adult Education Levels CRAM Impact pathway Improved Child and Maternal Nutrition Child Health Outcomes Dietary Diversity Household Asset Holding Food Availability (Hunger Gap) Reduce Negative Coping Strategies Improved levels of crop production Diversified Livelihood Changed KAP (to water, women…) Improved delivery of health services Adoption of good child care practices Access to and use of latrines Access to potable water Community Governance Structure Early Warning System and Response Social & Behavioural Change Access to Health and Nutrition Services Increased Participation of women Improved Agricultural Production for the Extreme Poor Access to Safe Water and Sanitation Services Assistance from other organisations Remittances Financial responsibility/ contribution of husband External Environment

8. Key findings…so far

9. Experience Difficulties achieving integration

10. Conclusions & Recommendations Learning from RAIN, Zambia on integration One overall goal Good understanding of context Move away from silo thinking in programme design Identify a clear funding stream Need to work constantly with teams to break down silos and shift away from focus on activities Strengthen human capacities and ensure strong leader in place

11. Conclusions & Recommendations Human Development Index Corruption Perceptions Index Government Effectiveness rankscorerankscore Percentile rank score Zambia141 st 0.56183 rd 38 -0.50 Chad184 th 0.372163 rd 195-1.49

12. Discussion points Integration is key to comprehensively addressing the causes of malnutrition – now also being aligned with the resilience agenda – how as nutritionists can we help improve integrated programming?