20TH– 23RD April, 2015



Carlos Acosta Bermudez

Economic Affairs Officer

Employment and Social Protection Section

Social Development Policy Division

UN Economic Commission for Africa


Semia Solange Guermas de Tapia

Social Affairs Officer

Urbanization Section

Social Development Policy Division

United Nations Economic Commission for Africa (ECA)


Kalkidan Assefa Kebede

Research Assistant

Cost of Hunger in Africa study WFP Representative Office to the AUC and UNECA




1. Background of the Mission 

The Cost of Hunger Study in Africa (COHA) is a project led by the African Union Commission and supported by the Economic Commission for Africa (ECA) and the World Food Programme (WFP). The study was completed in the first phase countries (Egypt, Ethiopia, Swaziland and Uganda) and almost finalized in the second phase pilot countries (Burkina Faso, Ghana, Malawi and Rwanda), and will be followed by Chad and additional countries. 

In all participating countries, the study is being implemented at country level by National Implementation Teams (NITs), including members from the Ministries of Health, Education, Social Development, Planning, and Finance, as well as National Statistics Institutions. The COHA study will increase the understanding of the consequences of child under-nutrition by estimating its social and economic costs on health services, educational achievement and national productivity. 

In December 2014, Chad formally launched the COHA in the country and established NIT. Following the launching and establishment of the NIT’s, the COHA team (NIT & RT) has been working on the data collection The team also agreed to come up with a working session to validate the collected data and do initial data analysis. Since then both the NIT’s in Chad and the Regional Team has been collecting primary and secondary level information to proceed with the study of the Social and Economic impact of under-nutrition for Chad. 


2. Objectives of the Mission 

The main objective of the Regional Team (RT) for the mission was to: 

      Review the primary and secondary collected data and do initial data analysis

      Assessing the data gap and coming up with alternative source of information 

      Validate data and initial level analysis based on the available data


3. Description of Results During the Mission  A. Finalization of Data collection (day 1 & 2)


The NITs together with the RT have taken the opportunity to finalize the data collection in terms of health and education sections. 

As part of this data collection a general review of all the collected data was undertaken in order to fine tune the data and explain remaining questions in this regard. 

This mission proved to be important, particularly as a step in the capacity building component of the NITS. Each of the specialists/representatives from the ministry of Economy and Planning, Health, Education, Statistics and a consult working for the health protocol and costing section had the opportunity to review the inputs and outputs of the model. As a result the data utilized for the COHA Chad was collected and initial level data processing was undertaken. 


Action Points: 

      The government expenditure on health, education and social public expenditure to be referred from the World Bank data

      To finalize the processing of the national household survey (Ecosit 3) to generate the average household annual expenditure per schooling years and age group.


B. Processing of Result and Presentation of the Initial Result (day3 & 4)

Having processed the model with the latest data collected, the RT shared the preliminary result with the NIT and went in to a more detailed analysis of these results. Subsequently, the RT and NIT prepared the presentation and further discussed on the presented result. 

In this working session it was agreed that the output of the preliminary analysis to be presented on the National Nutrition Summit for the purpose of showing the progress of the COHA Chad study and the next implementation process. 

After a thorough review, adjustment was made and the NIT was ready to take the lead in presenting the preliminary results of the COHA in the National Nutrition Summit (Presentation is attached as annex 1)


C. Developing the assumptions table and drafting a report for EU and National Nutrition Summit

Based on the inputs provided by the NIT, the team developed the assumption table which will be used as part of the final report to be prepared. During the processing and presentation of results, participants actively asked questions, give suggestions and noted the different assumptions considered during data collection. More specifically, a clarification was given to the different sources/references used for the study which are the best and most recent data available for the purpose of the study.


D. Bilateral Meetings

With WFP Country Director 


Immediately after arriving in Chad, the RT briefed the Country Director of WFP, Ms. Lauren R. Landis on the Cost of Hunger in Africa both in general and more country oriented the case of Chad in terms of processes undertaken and next steps (validation and launch). 

Ms. Landis thanks the mission for the support and recounted how the implementation of the COHA in Chad was an important element of the agenda to shift part of the dialogue with the governments and donors from emergency to a more structural discussion on development.

The mission thanked WFP CO for the support provided, both in logistical and substantive issues, and proceeded to discuss the expected outputs of the mission: 

i.                    Pending the availability and accuracy of the information, 2 main outputs are expected: 


      Preliminary results of the COHA to be shared by the NIT during a nutrition summit that will be held in the coming weeks

      A draft report of results to be shared with ECHO who financially supported the implementation of the project in Chad


ii.                  At the conclusions of the mission, a presentation was produced (annex….) which included the preliminary findings that the team was able to estimate. The report will be produced during the following week. 


With WFP/CO, EU/ECHO Representatives 

As part of a regular meeting between WFP/CO and EU/ECHO, the COHA was included as an agenda item and the mission was requested to provide an update on the process. After a brief recount of the regional scope and methodological elements of COHA, and shared some preliminary results of the study in Chad, the mission highlighted the following:

i.        The data collection process carried-out by the NIT to obtain data on health costs and protocol was very thorough. The team visited 7 of the 14 hospitals and consolidated data required by the study. However, given some important constraints in the availability of data in the administrative information system, the accuracy of the information depended to a large extent to caretaker’s recollection, which could generate issues on reliability.


ii.      The information on the household survey, necessary for the appropriate estimations of losses in productivity was still pending. Once the database is received, the data processing will allow the team to estimate further results of the study.


1. Outcomes and Steps Forward 


a.       Both primary and secondary data required for the COHA Chad have been successfully collected only remaining with accurate information on the household survey was still pending. The RT will work closely together with the national statistics office to further clarify the inconsistencies.

b.      The RT together with the NIT produced the preliminary result of the COHA Chad to be presented by the NIT during nutrition summit that will be held in the coming weeks. 

c.       A draft report will be shared by with ECHO who financially supported the implementation of the project in Chad (Early May).

d.      Drafting Initial Report: April-May 2015 

e.       End May 2015: Validation workshop

f.       May-June: Drafting final report

g.      June 2015: Launching of the final report