HKI country case studies [November 2017]

	A	B	C	D	E	G	H	I	J
1	Country	HKI's spending on VAS programs, 2013-2016 (in millions USD)	HKI's role in VAS programs, 2013 to 2016	Other organizations involved in VAS programs, 2013-16	VAS situation following HKI's loss of funding in March 2016	Primary type of impact HKI may have had on VAS programs, 2013-16	Supporting evidence for impact	Secondary type of impact HKI may have had on VAS programs, 2013-16	Supporting evidence for impact

2	Mali	$0.98	Providing technical and financial support for door-to-door and Child Health Day campaigns in two regions; implementing coverage surveys	UNICEF provided technical and financial support for two additional regions in Mali	UNICEF provided funding for a VAS distribution at the end of 2016, which included fixed and door-to-door distribution strategies. Mali was not included in UNICEF's 2016-2020 grant for VAS from Global Affiairs Canada. No mass campaigns for VAS have occurred in 2017. It appears unlikely that any polio campaigns (with VAS components) will take place in Mali in the future.	Enabling mass campaigns to occur	No mass campaigns have occurred in 2017. UNICEF no longer has funding available to support mass campaigns of VAS in Mali.
3	Cote d'Ivoire	$1.40	Providing technical and financial support for door-to-door VAS campaigns (tied to polio campaigns) for the whole country	Nutrition International provided funding for vitamin A supplements	The government of Cote d'Ivoire implemented a Child Heath Week program in the latter half of 2016 without support from external partners. It appears likely that the program did not achieve high coverage rates—because the campaign had a limited budget, it was not able to reach many districts at all. Two polio campaigns (with VAS components) were implemented in 2017. Funding for the polio campaigns was available because of the discovery of a few wild polio cases in Nigeria. It is unclear whether funding for polio campaigns (with VAS components) will be available in 2018.	Enabling mass campaigns to occur by providing funding to governments	To date, no VAS mass campaigns have been skipped due to lack of funding.	Improving VAS coverage rates by providing technical assistance	HKI told us that it is likely that the Child Health Day program in late 2016 achieved low coverage without external assistance from HKI, due to lack of funding and lack of technical support for program planning.
4	Kenya	$1.40	In 2008, the government of Kenya decided to distribute vitamin A supplements through Malezi Bora (Child Health Days). It had previously distributed vitamin A in door-to-door campaigns, and had achieved around 90% coverage. HKI told us that, from 2008 to 2013, VAS coverage in Kenya dropped to around 20%. HKI began providing technical and financial assistance to 10 counties in Kenya in 2013. HKI reports that, with its assistance, these counties were able to reach 50% coverage.	Nutrition International provided funding for vitamin A supplements	HKI told us that it is likely that coverage is low. More specific information is not available because no coverage surveys have been conducted.	Increasing coverage rates	We have seen the results of one coverage survey in Kenya, from 2013, which found 58% coverage in two sub-counties. We have not seen data on coverage rates between 2008 and 2013.
5	Niger	$0.82	Providing technical and financial support for door-to-door VAS campaigns (tied to polio campaigns) for the whole country; implementing coverage surveys.	UNICEF also provided technical and financial support for VAS campaigns throughout the country. Nutrition International funded the purchase of vitamin A supplements.	No campaigns have been skipped. In December 2016, a Child Survival Week campaign occurred, and included distribution of VAS. UNICEF provided funding for the campaign. In April 2017, a door-to-door polio campaign including vitamin A occurred. Another campaign is planned for December 2017.	Increasing coverage rates	HKI told us that it was concerned that hard-to-reach areas were being missed in campaigns following HKI's loss of funding. We have not seen information that would allow us to estimate how much coverage rates may have dropped.
6	Guinea	$0.89	Providing technical and financial support for door-to-door VAS campaigns (tied to polio campaigns) for the whole country; implementing coverage surveys. VAS campaigns were not implemented in 2014 and in the first half of 2015 due to the Ebola outbreak. With the exception of campaigns skipped due to the Ebola epidemic, at least two mass distribution campaigns for VAS had occurred every year since HKI began supporting VAS campaigns in Guinea in 2000.	UNICEF also provided technical and financial support for VAS campaigns throughout the country. Nutrition International funded the purchase of vitamin A supplements.	Guinea's government has decided to switch from tying VAS to door-to-door polio campaigns to distributing it through Child Health Weeks, using a fixed site and outreach distribution strategy. In 2016, there was only one mass distribution of VAS in a Child Health Week in the latter half of the year. Sufficient funding for a second Child Health Week campaign was not available. In 2017, only one mass distribution of VAS occurred, during a Child Health Week in October 2017. Sufficient funding for a second campaign was not available. HKI and the Ministry of Health expect that there will only be sufficient funding for one mass distribution of VAS through a Child Health Week in 2018 if HKI does not receive additional funding.	Enabling mass campaigns to occur by providing funding to governments	After HKI's Global Affairs Canada grant ended, two mass campaigns have been skipped (in 2016 and 2017) due to lack of available funding.	Improving VAS coverage rates by providing technical assistance	We have seen three coverage surveys from regions in Guinea from 2013. All three found coverage rates over 80%. We do not have evidence on what coverage rates might have been in HKI's absence.
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8						Impacts in green cells have supporting evidence GiveWell judges to be reasonably strong
9						Impacts in yellow cells have weaker supporting evidence
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