The Dar Sila region of eastern Chad experiences highly variable rainfall, seasonal food insecurity, and high prevalence of acute malnutrition. In 2012, Concern Worldwide put in place an integrated program that combines nutrition, health, water, sanitation, and hygiene (WASH), and food, income, and markets (FIM) in the Dar Sila Region of Chad called Community Resilience to Acute Malnutrition (CRAM). This program was designed to reduce child acute malnutrition in the face of seasonal shocks.
The CRAM design was based on Concern’s positive programming experiences in Kenya and Niger. Concern collaborated with the Feinstein International Center, Friedman School of Nutrition Science and Policy at Tufts University to carry out a randomized control trial impact evaluation to better understand the level of program impact and the mechanisms behind it.