Botswana’s Vulnerable Groups Feeding Programme (VGFP) had its roots in drought relief efforts initiated around the time of Botswana’s independence in 1966. It became a blanket supplementary feeding scheme, administered through health facilities across the country, to improve the nutrition of children under five, selected pregnant and lactating women, and tuberculosis and leprosy outpatients. As there had never been an evaluation of the VGFP, the objective of this evaluation was to inform policy and programme design to maximise social outcomes, including on stunting.

The evaluation was both summative and formative in nature. Adopting a theory-based mixed-methods approach, it assessed the performance of the VGFP in the past in terms of its relevance, efficiency, effectiveness, impact and sustainability (summative) and made evidence-based proposals on how Botswana’s stunting challenge might be tackled more effectively (formative). Mokoro’s team was led by Stephen Turner, and included inputs from colleagues from the Botswana Institute for Development Policy Analysis (BIDPA). The evaluation included in-country fieldwork, an online survey, a telephone survey, key informant interviews and analysis of existing data and documentation.

The team’s findings and recommendations were written up in the final Evaluation Report and an Investment Case for Nutrition. The main finding was that, irrespective of broader design issues, the VGFP had been ineffective due to the low quantity of rations reaching the target recipients. The Investment Case for Nutrition therefore suggested three options:

A. The conservative option: to strengthen the VGFP’s impact through better procurement and distribution, and more effective rations.

B. To retain the VGFP while seeking to optimise the system by reducing some facets, strengthening others, and supporting these changes with increased community healthcare and improved social protection policies.

C. A radical rethinking of nutrition programming, phasing out the VGFP, except for in crisis situations, and replacing it with a multi-sectoral approach to nutrition, incorporating stronger social protection policies that are more appropriate for a stable and economically strong country like Botswana.