"programme_id","programme_title","programme_language","programme_type","other_program","iso3code","country_name","program_location","area","status","start_date","end_date","brief_description","references","related_policy","new_policy","partner_gov","partner_government_details","partner_un","partner_un_details","partner_ngo","partner_ngo_details","partner_donors","partner_donors_details","partner_intergov","partner_intgov_details","partner_national_ngo","partner_nat_ngo_details","partner_research","partner_research_details","partner_private","partner_private_details","partner_other","partner_other_details","cost","fsector_0","fpartner_0","fdetails_0","fsector_1","fpartner_1","fdetails_1","fsector_2","fpartner_2","fdetails_2","fsector_3","fpartner_3","fdetails_3","fsector_4","fpartner_4","fdetails_4","fsector_5","fpartner_5","fdetails_5","fsector_6","fpartner_6","fdetails_6","fsector_7","fpartner_7","fdetails_7","fsector_8","fpartner_8","fdetails_8","fsector_9","fpartner_9","fdetails_9","fsector_10","fpartner_10","fdetails_10","fsector_11","fpartner_11","fdetails_11","fsector_12","fpartner_12","fdetails_12","fsector_13","fpartner_13","fdetails_13","fsector_14","fpartner_14","fdetails_14","fsector_15","fpartner_15","fdetails_15","fsector_16","fpartner_16","fdetails_16","fsector_17","fpartner_17","fdetails_17","fsector_18","fpartner_18","fdetails_18","fsector_19","fpartner_19","fdetails_19","fsector_20","fpartner_20","fdetails_20","fsector_21","fpartner_21","fdetails_21","fsector_22","fpartner_22","fdetails_22","fsector_23","fpartner_23","fdetails_23","fsector_24","fpartner_24","fdetails_24","fsector_25","fpartner_25","fdetails_25","fsector_26","fpartner_26","fdetails_26","fsector_27","fpartner_27","fdetails_27","fsector_28","fpartner_28","fdetails_28","fsector_29","fpartner_29","fdetails_29","fsector_30","fpartner_30","fdetails_30","fsector_31","fpartner_31","fdetails_31","fsector_32","fpartner_32","fdetails_32","fsector_33","fpartner_33","fdetails_33","fsector_34","fpartner_34","fdetails_34","fsector_35","fpartner_35","fdetails_35","fsector_36","fpartner_36","fdetails_36","fsector_37","fpartner_37","fdetails_37","fsector_38","fpartner_38","fdetails_38","fsector_39","fpartner_39","fdetails_39","fsector_40","fpartner_40","fdetails_40","fsector_41","fpartner_41","fdetails_41","fsector_42","fpartner_42","fdetails_42","fsector_43","fpartner_43","fdetails_43","fsector_44","fpartner_44","fdetails_44","fsector_45","fpartner_45","fdetails_45","fsector_46","fpartner_46","fdetails_46","fsector_47","fpartner_47","fdetails_47","fsector_48","fpartner_48","fdetails_48","fsector_49","fpartner_49","fdetails_49","action_id","theme","topic","new_topic","micronutrient","micronutrient_compound","target_group","age_group","place","delivery","other_delivery","dose_frequency","impact_indicators","me_system","target_pop","coverage_percent","coverage_type","baseline","post_intervention","social_det","social_other","elena_link","problem_0","solution_0","problem_1","solution_1","problem_2","solution_2","problem_3","solution_3","problem_4","solution_4","problem_5","solution_5","problem_6","solution_6","problem_7","solution_7","problem_8","solution_8","problem_9","solution_9","other_problems","other_lessons","personal_story","language" "8891","Double Burden of Malnutrition: Hub in West Africa","English","Multi-national","","BEN|BFA|MLI","Benin|Burkina Faso|Mali","Benin|Burkina Faso|Mali","Urban","on-going","01-2008","01-2014","
The 6-year partnership project (2008-2014) involves TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Developement, academic and research institutions from Benin, Burkina Faso and Mali, Helen Keller International, an international NGO, and WHO as special collaborator. The purpose of the project is to strengthen capacity of partner countries to address the double burden of the coexistence of undernutrition and nutrition-related chronic diseases.The strategy includes: 1) Workforce training in nutrition with two new regional university programs in Benin, a Master's and an undetrgraduate professional program (licence), as well as continuous intensive courses on Nutrition Transition and Chronic Diseases, and Community Management of acute malnutrition; 2) Action research in communities (Benin) and schools (Benin and Burkina Faso), and other studies on the nutrition transition and the double burden of malnutrition; 3) Communication for the public with development of a food guide for Benin, and the development of advocacy tools for policy and programs focusing on diabetes.
","Website: www.poleDFN.org
Publications:
Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Applied Physiol Nutr Metab 2010; 35: 224-8.
Daboné C, Receveur O, Delisle H. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou. Nutrition Journal 2011; Apr 19;10:34.
Delisle H, Ntandou G, Agueh V, Sodjinou R, Fayomi B. Urbanisation, nutrition transition and cardiometabolic risk: the Benin Study. Brit J Nutr 2011; 107: 1534-44 (doi:10.1017/S0007114511004661)
Sossa J, Delisle H, Agueh V, Makoutodé M, Fayomi B. Four-year trends in cardiometabolic risk factors according to baseline abdominal obesity status in West-African adults: The Benin Study. J Obesity 2012 doi: 10.1155/2012/740854
Zeba A, Delisle H, Renier G, Savadogo B, Banza B. The double burden of malnutrition and cardio-metabolic risk widens the gender and socioeconomic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15: 2210-9
Zeba A, Delisle H, Rossier C, Renier G. Association of high-sensitive C-reactive protein (hsCRP) with cardio-metabolic risk factors and micronutrient deficiencies in adults of Ouagadougou; Burkina Faso. Brit J Nutr (Accepted)
Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts. BMC International Health & Human Rights 2011; 11 (suppl 2): S10 http://www.biomedcentral.com/bmcinthealthhumrights/supplements/11/S2
Delisle H, Agueh V, Fayomi B. Recherche en partenariat sur la transition nutritionnelle et les maladies chroniques en Afrique de l’ouest – évolution, résultats et retombées. CRDI, 2011. Disponible à : http://www.crdi.ca/irsm10etudesdecas
Delisle H, Receveur O, Agueh V, Nishida C. Pilot-testing of the Nutrition-Friendly School Initiative in West Africa in Ouagadougou (Burkina Faso) and Cotonou (Benin). Global Health Promotion (in press)
Sossa C, Delisle H, Agueh V, Makoutodé M, Fayomi B. Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: The Benin Study. (NMCD, in press)
Daboné C, Delisle H, Receveur O. Cardiometabolic risk factors and associated features in 5th grade school children in Ouagadougou, Burkina Faso. Int J Child Health Nut 2012 (In press)
Daboné C, Delisle H, Receveur O. Predisposing, facilitating and reinforcing factors of healthy and unhealthy food consumption in schoolchildren. A study in Ouagadougou, Burkina Faso (West Africa). Global Health Promotion 2012 (in press)
Delisle H. Empowering our profession in Africa. World Nutrition 2012; 3: 269-84: http://www.wphna.org/2012_may_hp6_this_month.htm
","8811|8621|8622|8554","","","","","","Helen Keller International (HKI)","Particularly in Burkina Faso","","","","","National NGOs","Mali: Santé-Diabète (French NGO)","Research/academia","Benin: Regional Public Health Institute (IRSP); Faculty of Health Sciences, Abomey-Calavi University; Appiled Biomedical Science Institute (ISBA); Burkina Faso: Research Institute on Health Sciences (IRSS); Ouagadougou University (Medicine; CRSBAN); Mali: University of Bamako and university hospital; University of Montreal, Canada, TRANSNUT, Department of Nutrition","","","","","Total: ~5 million CAD, including 3 million CAD provided by Canadian International Development Agency","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","University of Montreal contributes ~1.3 million CAD and African partner institution, ~700.000CAD","Research/academia","Research/academia","NFSI implemented on a pilot basis in primary schools of Cotonou (n=6) and in Ouagadougou (n=6). In Ouagadougou, quasi-experimental approach, with 6 matched control schools. Baseline study conducted on nutritional status of pupils (nearly 900), and hygiene and eating practices. Implementation with Nutrition & Health Committees in schoolds. DFN project trained in nutrition education and surveillance (using anthropometry). Other activities elected by individual schools.
","Nutritional status of pupils after 3 years of NFSI implementation, and their hygiene and eating practices.
","","Undefined","Undefined","","Baseline study in Ouagadougou in 2009","Due in 2013
","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8891","Double Burden of Malnutrition: Hub in West Africa","English","Multi-national","","BEN|BFA|MLI","Benin|Burkina Faso|Mali","Benin|Burkina Faso|Mali","Urban","on-going","01-2008","01-2014","The 6-year partnership project (2008-2014) involves TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Developement, academic and research institutions from Benin, Burkina Faso and Mali, Helen Keller International, an international NGO, and WHO as special collaborator. The purpose of the project is to strengthen capacity of partner countries to address the double burden of the coexistence of undernutrition and nutrition-related chronic diseases.The strategy includes: 1) Workforce training in nutrition with two new regional university programs in Benin, a Master's and an undetrgraduate professional program (licence), as well as continuous intensive courses on Nutrition Transition and Chronic Diseases, and Community Management of acute malnutrition; 2) Action research in communities (Benin) and schools (Benin and Burkina Faso), and other studies on the nutrition transition and the double burden of malnutrition; 3) Communication for the public with development of a food guide for Benin, and the development of advocacy tools for policy and programs focusing on diabetes.
","Website: www.poleDFN.org
Publications:
Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Applied Physiol Nutr Metab 2010; 35: 224-8.
Daboné C, Receveur O, Delisle H. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou. Nutrition Journal 2011; Apr 19;10:34.
Delisle H, Ntandou G, Agueh V, Sodjinou R, Fayomi B. Urbanisation, nutrition transition and cardiometabolic risk: the Benin Study. Brit J Nutr 2011; 107: 1534-44 (doi:10.1017/S0007114511004661)
Sossa J, Delisle H, Agueh V, Makoutodé M, Fayomi B. Four-year trends in cardiometabolic risk factors according to baseline abdominal obesity status in West-African adults: The Benin Study. J Obesity 2012 doi: 10.1155/2012/740854
Zeba A, Delisle H, Renier G, Savadogo B, Banza B. The double burden of malnutrition and cardio-metabolic risk widens the gender and socioeconomic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15: 2210-9
Zeba A, Delisle H, Rossier C, Renier G. Association of high-sensitive C-reactive protein (hsCRP) with cardio-metabolic risk factors and micronutrient deficiencies in adults of Ouagadougou; Burkina Faso. Brit J Nutr (Accepted)
Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts. BMC International Health & Human Rights 2011; 11 (suppl 2): S10 http://www.biomedcentral.com/bmcinthealthhumrights/supplements/11/S2
Delisle H, Agueh V, Fayomi B. Recherche en partenariat sur la transition nutritionnelle et les maladies chroniques en Afrique de l’ouest – évolution, résultats et retombées. CRDI, 2011. Disponible à : http://www.crdi.ca/irsm10etudesdecas
Delisle H, Receveur O, Agueh V, Nishida C. Pilot-testing of the Nutrition-Friendly School Initiative in West Africa in Ouagadougou (Burkina Faso) and Cotonou (Benin). Global Health Promotion (in press)
Sossa C, Delisle H, Agueh V, Makoutodé M, Fayomi B. Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: The Benin Study. (NMCD, in press)
Daboné C, Delisle H, Receveur O. Cardiometabolic risk factors and associated features in 5th grade school children in Ouagadougou, Burkina Faso. Int J Child Health Nut 2012 (In press)
Daboné C, Delisle H, Receveur O. Predisposing, facilitating and reinforcing factors of healthy and unhealthy food consumption in schoolchildren. A study in Ouagadougou, Burkina Faso (West Africa). Global Health Promotion 2012 (in press)
Delisle H. Empowering our profession in Africa. World Nutrition 2012; 3: 269-84: http://www.wphna.org/2012_may_hp6_this_month.htm
","8811|8621|8622|8554","","","","","","Helen Keller International (HKI)","Particularly in Burkina Faso","","","","","National NGOs","Mali: Santé-Diabète (French NGO)","Research/academia","Benin: Regional Public Health Institute (IRSP); Faculty of Health Sciences, Abomey-Calavi University; Appiled Biomedical Science Institute (ISBA); Burkina Faso: Research Institute on Health Sciences (IRSS); Ouagadougou University (Medicine; CRSBAN); Mali: University of Bamako and university hospital; University of Montreal, Canada, TRANSNUT, Department of Nutrition","","","","","Total: ~5 million CAD, including 3 million CAD provided by Canadian International Development Agency","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","University of Montreal contributes ~1.3 million CAD and African partner institution, ~700.000CAD","Research/academia","Research/academia","The Master's program in Public Health Nutrition started at the Regional Institute of Public Health in 2009 and a first cohort of 10 graduates finished in 2011. A new cohort of 10 students started in October 2012. Regarding the 3-year undergraduate professional program in Nutrition and Dietetics, the 3-year program is offered at the Faculty of Health Studies School of Nutrition since 2010. A first cohort of 20 will get their degree (licence) in July 2013.
","Number, sex, and position of graduates
","","N/A","N/A","","","","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8891","Double Burden of Malnutrition: Hub in West Africa","English","Multi-national","","BEN|BFA|MLI","Benin|Burkina Faso|Mali","Benin|Burkina Faso|Mali","Urban","on-going","01-2008","01-2014","The 6-year partnership project (2008-2014) involves TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Developement, academic and research institutions from Benin, Burkina Faso and Mali, Helen Keller International, an international NGO, and WHO as special collaborator. The purpose of the project is to strengthen capacity of partner countries to address the double burden of the coexistence of undernutrition and nutrition-related chronic diseases.The strategy includes: 1) Workforce training in nutrition with two new regional university programs in Benin, a Master's and an undetrgraduate professional program (licence), as well as continuous intensive courses on Nutrition Transition and Chronic Diseases, and Community Management of acute malnutrition; 2) Action research in communities (Benin) and schools (Benin and Burkina Faso), and other studies on the nutrition transition and the double burden of malnutrition; 3) Communication for the public with development of a food guide for Benin, and the development of advocacy tools for policy and programs focusing on diabetes.
","Website: www.poleDFN.org
Publications:
Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Applied Physiol Nutr Metab 2010; 35: 224-8.
Daboné C, Receveur O, Delisle H. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou. Nutrition Journal 2011; Apr 19;10:34.
Delisle H, Ntandou G, Agueh V, Sodjinou R, Fayomi B. Urbanisation, nutrition transition and cardiometabolic risk: the Benin Study. Brit J Nutr 2011; 107: 1534-44 (doi:10.1017/S0007114511004661)
Sossa J, Delisle H, Agueh V, Makoutodé M, Fayomi B. Four-year trends in cardiometabolic risk factors according to baseline abdominal obesity status in West-African adults: The Benin Study. J Obesity 2012 doi: 10.1155/2012/740854
Zeba A, Delisle H, Renier G, Savadogo B, Banza B. The double burden of malnutrition and cardio-metabolic risk widens the gender and socioeconomic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15: 2210-9
Zeba A, Delisle H, Rossier C, Renier G. Association of high-sensitive C-reactive protein (hsCRP) with cardio-metabolic risk factors and micronutrient deficiencies in adults of Ouagadougou; Burkina Faso. Brit J Nutr (Accepted)
Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts. BMC International Health & Human Rights 2011; 11 (suppl 2): S10 http://www.biomedcentral.com/bmcinthealthhumrights/supplements/11/S2
Delisle H, Agueh V, Fayomi B. Recherche en partenariat sur la transition nutritionnelle et les maladies chroniques en Afrique de l’ouest – évolution, résultats et retombées. CRDI, 2011. Disponible à : http://www.crdi.ca/irsm10etudesdecas
Delisle H, Receveur O, Agueh V, Nishida C. Pilot-testing of the Nutrition-Friendly School Initiative in West Africa in Ouagadougou (Burkina Faso) and Cotonou (Benin). Global Health Promotion (in press)
Sossa C, Delisle H, Agueh V, Makoutodé M, Fayomi B. Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: The Benin Study. (NMCD, in press)
Daboné C, Delisle H, Receveur O. Cardiometabolic risk factors and associated features in 5th grade school children in Ouagadougou, Burkina Faso. Int J Child Health Nut 2012 (In press)
Daboné C, Delisle H, Receveur O. Predisposing, facilitating and reinforcing factors of healthy and unhealthy food consumption in schoolchildren. A study in Ouagadougou, Burkina Faso (West Africa). Global Health Promotion 2012 (in press)
Delisle H. Empowering our profession in Africa. World Nutrition 2012; 3: 269-84: http://www.wphna.org/2012_may_hp6_this_month.htm
","8811|8621|8622|8554","","","","","","Helen Keller International (HKI)","Particularly in Burkina Faso","","","","","National NGOs","Mali: Santé-Diabète (French NGO)","Research/academia","Benin: Regional Public Health Institute (IRSP); Faculty of Health Sciences, Abomey-Calavi University; Appiled Biomedical Science Institute (ISBA); Burkina Faso: Research Institute on Health Sciences (IRSS); Ouagadougou University (Medicine; CRSBAN); Mali: University of Bamako and university hospital; University of Montreal, Canada, TRANSNUT, Department of Nutrition","","","","","Total: ~5 million CAD, including 3 million CAD provided by Canadian International Development Agency","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","University of Montreal contributes ~1.3 million CAD and African partner institution, ~700.000CAD","Research/academia","Research/academia","Food-based dietary guidelines, including an illustrated food guide, is being developed in Benin with partner institutions. The urban population in particular is targeted. These nutrition communication tools were based on WHO/FAO recommendations and on recent dietary intake studies in the southern part of Benin.
","Formal acceptation of dietary guidelines by authorities of Benin
","","Approximately 3 million people (urban and peri-urban population of southern Benin)","Undetermined","","","","None","","","","","","","","","","","","","","","","","","","","","","","","","","English" "14601","GAIN Large-scale Food Fortification Program","English","National","","CIV","Côte d'Ivoire","Côte d'Ivoire","","completed","09-2005","08-2009","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14600","","Oil fortification","","Vitamin A","","All population groups","","National population","","","Vegetable Oil","","","","","","","","","","Vitamin A fortification of staple foods>>>Vitamin A fortification of staple foods>>http://www.who.int/elena/titles/vitamina_fortification","","","","","","","","","","","","","","","","","","","","","","","","" "14601","GAIN Large-scale Food Fortification Program","English","National","","CIV","Côte d'Ivoire","Côte d'Ivoire","","completed","09-2005","08-2009","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14602","","Wheat flour fortification","","Iron|Folic acid","","All population groups","","National population","","","Wheat Flour","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "14604","GAIN Nutritious Foods for Mothers and Children","English","National","","CIV","Côte d'Ivoire","Côte d'Ivoire","","on-going","12-2010","08-2014","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","Private sector","Protéin Kisée-Là (PKL) ","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14603","","Complementary food fortification","","Iodine|Iron|Zinc|Vitamin A|Vitamin D|B vitamins|Folic acid","","Infants and young children","Children 6-23 months","National population","Commercial","","Fortified Complementary Food (Farinor); Besides iodine, iron, folic acid, zinc and vitamins A, B and D, the Fortified Complementary Foods contain additional micronutrients. GAIN advises its partners to formulate products according to the GAIN Nutritional Guidelines for Complementary Foods and Complementary Food Supplements:","","","","","","","","","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","" "14667","GAIN Large-scale Food Fortification Program","English","National","","MLI","Mali","Mali","","completed","09-2004","06-2008","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14666","","Oil fortification","","Vitamin A","","All population groups","","National population","","","Vegetable Oil","","","","","","","","","","Vitamin A fortification of staple foods>>>Vitamin A fortification of staple foods>>http://www.who.int/elena/titles/vitamina_fortification","","","","","","","","","","","","","","","","","","","","","","","","" "14669","GAIN Large-scale Food Fortification Program","English","National","","MOZ","Mozambique","Mozambique","","on-going","03-2011","04-2015","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14668","","Oil fortification","","Vitamin A","","All population groups","","National population","","","Vegetable Oil","","","","","","","","","","Vitamin A fortification of staple foods>>>Vitamin A fortification of staple foods>>http://www.who.int/elena/titles/vitamina_fortification","","","","","","","","","","","","","","","","","","","","","","","","" "14669","GAIN Large-scale Food Fortification Program","English","National","","MOZ","Mozambique","Mozambique","","on-going","03-2011","04-2015","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14670","","Wheat flour fortification","","Iron|Zinc|B vitamins|Folic acid","","All population groups","","National population","","","Wheat Flour","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "14694","GAIN Large-scale Food Fortification Program","English","National","","TZA","United Republic of Tanzania","Tanzania","","on-going","02-2011","07-2013","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14693","","Oil fortification","","Vitamin A","","All population groups","","National population","","","Vegetable Oil","","","","","","","","","","Vitamin A fortification of staple foods>>>Vitamin A fortification of staple foods>>http://www.who.int/elena/titles/vitamina_fortification","","","","","","","","","","","","","","","","","","","","","","","","" "14694","GAIN Large-scale Food Fortification Program","English","National","","TZA","United Republic of Tanzania","Tanzania","","on-going","02-2011","07-2013","","http://www.gainhealth.org/countries
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","International NGOs","Global Alliance for Improved Nutrition (GAIN)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","14695","","Wheat flour fortification","","Iron|Zinc|B vitamins|Folic acid","","All population groups","","National population","","","Wheat Flour","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "23172","HKI programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Yako","English","Community/sub-national","","BFA","Burkina Faso","Yako, Burkina Faso","Rural","on-going","07-2012","","Helen Keller International (HKI) a démarré progressivement à partir de juillet 2012 un programme d’appui pour la mise en oeuvre de la Prise en Charge de la Malnutrition Aiguë (PCMA) dans 52 formations sanitaires (CSPS) du district sanitaire de Yako. Ceci suite à l´appel de soutien national et international du Gouvernement de Burkina pour faire face à la crise alimentaire et nutritionnelle officiellement déclarée après la faible récolte de 2011.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Yako:
http://www.coverage-monitoring.org/wp-content/uploads/2013/04/Yako-BF_02_2013.pdf
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23171","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois ","District de Yako","Primary health care center","","","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
1. Données quantitatives: données de routine du programme et données collectées au cours d’enquêtes sur des petites et grandes zones.
- Tendance des admissions et abandons au cours du temps et en fonction des évènements locaux
- Performance du programme
- Périmètre Brachial (PB) a l´admission
- Durée du séjour
2. Données qualitatives: informations collectées auprès de personnes clés au niveau de la communauté ou des acteurs et bénéficiaires impliqués dans le service à travers d´entretiens individuels et discussions en groupe.
La collecte d´informations qualitatives a été réalisée dans un total de 28 villages du district sanitaire de Yako.
Les méthodes suivantes ont été utilisées pour la collecte d´information qualitative:
- Groupes informels de discussion/focus groups
- Entretiens semi-structurés
- Étude de cas
- Observation
","Cinq mois après le début de l´appui effectif du programme, une évaluation de la couverture du programme de PCMA dans l´ensemble du district a été réalisée par HKI du 11 au 26 février 2013, au moyen de la méthode SQUEAC. L´outil SQUEAC permet par conséquent d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
Etape 1: Identification des zones de couverture élevée ou faible et des barrières à l’accessibilité
Etape 2: Vérification des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
Etape 3: Estimation de la couverture globale
","L’aire du district sanitaire de Yako a une population estimée à 372 403 habitants en 2012 (RGPH 2006).","30.8% [IC 95%: 21.3% ‐ 42.1%] ","Point","Selon l’enquête SMART 2011 (Direction de Nutrition du Ministère de la santé), la prévalence de la malnutrition globale dans le district de Yako était de 11.8% contre 10.6% au niveau national et la prévalence de malnutrition aiguë sévère de 2.4%.","","None","","","Management","","Communication","","Management","","Management","","","","","","","","","","","","","","","Principaux barrières à la couverture
Distance et inaccessibilité
L’accès physique au Centre de Santé et de Promotion Sociale (CSPS) est un problème pour les bénéficiaires de certains villages à cause de la distance ou des difficultés d’accès géographiques, spécialement pendant la saison de pluies. Le manque de moyen de transport (vélo pas toujours disponible pour la mère) constitue l´obstacle principal là où la distance à se déplacer est longue.
Occupation des mères
Le manque de temps des mères pour amener les enfants de façon hebdomadaire au CSPS a été confirmé comme une barrière très important dans le contexte de Yako. Les motifs sont divers: les responsabilités familiales (autres enfants), les occupations ménagères –orpaillage entre autres-, devenir malade elle-même et/ou l´assistance aux évènements sociaux comme les funérailles, de grand importance dans la communauté.
Stigmatisation de la malnutrition
Le problème de la stigmatisation de la malnutrition a été reconnu par plusieurs acteurs, y comprises les femmes de la communauté et même les mères des enfants dans le programme. Dans la plupart des cas, la honte de montrer dans la communauté un enfant souffrant de malnutrition est enracinée dans la croyance que la cause de la maladie est liée à la grossesse rapprochée.
Communication pour le Changement du Comportement insuffisante
L´insuffisance de sensibilisation et communication à la communauté a été constatée à partir du niveau élevé de méconnaissance de la malnutrition trouvé au cours de l´investigation et faible implication des hommes. Bien que les signes de la forme marasmique semblent être plus reconnus que la forme kwashiorkor (pratiquement inconnu), les causes et conséquences de la malnutrition ne sont pas intégrées dans les connaissances de la communauté. Il y a aussi une certaine méconnaissance sur les aspects pratiques de traitement, comme par exemple la croyance de que la diarrhée peut être provoquée par la consommation du Plumpy Nut.
Inobservance du traitement
Partager l´ATPE avec des autres membres de la famille et/ou cesser d´aller au CSPS les jours de suivi de PCA à cause de l´apparence amélioré du malade sont les raisons qui font que l´enfant ne suit pas le traitement adéquatement.
Dépistage/référence/coût-opportunité
Les dépistages actifs par les Agents de Santé Communautaire sont pas continus, en lien avec le manque de motivation financière régulière (activité bénévole, seulement les formations sont payés) et parfois la manque d´outils de dépistage et équipement. L´absence de ASC dans certains villages a été aussi constatée, tout cela se traduit en un manque de référence. Au niveau de CSPS, le dépistage de routine en consultation est souvent limité aux jours de prise en charge et la communication entre le personnel et les ASC est déficient.
Qualité du service au niveau CSPS
Diverse aspects liés à la qualité du service dans les formations sanitaires ont été soulevés. Le personnel des centres ont remarqué l´insuffisance de ressources humaines et les mères des enfants le manque de communication interpersonnelle et les longues attentes. De façon générale, la discontinuité du service de prise en charge (une fois par semaine) avec le non-respect de protocole par rapport à particularités comme le non réalisation systématique du test de l´appétit représentent les barrières plus remarquables à niveau service de santé.
Rejet
Existence du phénomène de rejet des cas MAS en lien avec la discontinuité de la Prise en Charge Ambulatoire.
Rupture de stock
La rupture d´intrants (d´ATPE et/ou médicaments), qui se passe de façon ponctuel au niveau des CSPS, montre un problème de gestion et d´approvisionnement car la disponibilité des produits au niveau central est assurée pour le programme MAS.
Insuffisance d´implication des autorités sanitaires et/ou locales
Les autorités locales ne sont pas impliquées dans le programme. Au niveau des autorités sanitaires du DS et la collaboration avec des organisations qui travaillent dans le domaine de la PCMA, il y a une absence de cadre de concertation entre les acteurs et une programmation des activités insuffisante.
Abandons
Les principaux motifs d´abandon entre les mères entretenus à travers la petite étude de suivi des plus récents abandons sont: la stigmatisation, l´occupation de la mère, l´absence de moyen de transport, l´inobservance du traitement, la manque de communication a niveau de CSPS, avoir été rejeté auparavant et la discontinuité du service.
","","English" "23199","CICR programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Gorom Gorom","English","Community/sub-national","","BFA","Burkina Faso","gorom gorom, burkina faso","Rural","on-going","","","La Croix Rouge de Belgique, en partenariat avec la Croix Rouge burkinabè et les autorités sanitaires ont mis en oeuvre depuis 2007 un programm d’appui aux structures sanitaires dans neuf provinces réparties dans 3 régions (Sahel, Nord, Centre Ouest).Pour la région du Sahel, le passage à l’échelle s’est fait à partir de 2011 par des phases successives sous financement ECHO (European Community Humanitarian aid Office). Aujourd’hui, le programme couvre les 18 Centre de Santé et de Promotion Sociale (CSPS) du District Sanitaire de Gorom Gorom. Le programme est actuellement en phase 6, phase ayant débutée en mars 2013 qui prendra fin en janvier 2014. Cette phase prévoit de consolider l’appui au système de santé de la région du Sahel en vue d’accroitre son efficacité dans la prise en charge ambulatoire de la malnutrition aigüe à travers des appuis techniques et financiers touchant à la fois la qualité, la couverture, le suivi/évaluation et la capitalisation de la prise en charge de la malnutrition aigüe.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Gorom Gorom:
","","","","","","","International Committee of the Red Cross (ICRC)","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23198","","Management of severe acute malnutrition","","","","SAM child","Enfants de 0 à 59 mois","District de Gorom Gorom","Community-based|Primary health care center","","Le cadre approprié pour la prise en charge de la malnutrition aiguë modérée est constitué des Centres de Santé et de Promotion Sociale (CSPS), des Centres Médicaux avec Antenne Chirurgicale (CMA) ou tout autre structure menant des activités de supplémentation alimentaire. En période d’urgence des Centres de Supplémentation Nutritionnelle (CSN) pourront être ouverts à cet effet.
Le cadre approprié de la prise en charge de la malnutrition sévère est le centre de récupération et d’éducation nutritionnelle (CREN). Son rôle principal est le traitement de la malnutrition sévère et l’éducation des familles en matière de nutrition.
Là où il n’existe pas de CREN, les CSPS doivent assurer une prise en charge en externe des cas adaptés à ce mode de traitement.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du 1 au 20 novembre 2013 en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Aux recommandations ci-dessus sont ajoutées des recommandations spécifiques à l’attention:
De la Croix Rouge de Belgique:
-Evaluation des Centre d’Accueil Pour Nutrition (CAPN),
-Définition de la stratégie communautaire sur plusieurs années,
-Réflexion de concert avec la DRS et les DS (en impliquant les CISSE et les Points Focaux Nutrition) au concept CAPN et ses orientations en vue d’une meilleure intégration dans le système sanitaire,
-Travail conjoint avec la Direction Régionale de la Santé et les District Sanitaire sur un système harmonisé de collecte des données communautaires incluant tous les paramètres de suivi de la MAS (base de données complémentaires)
-Renforcement des ressources humaines des formations sanitaires en personnel additionnel,
-Révision de l’organisation terrain depuis le pôle technique jusqu’au positionnement des agents de terrain.
De la Direction régionale de la Santé du Sahel:
-Suivi de la mise en oeuvre des recommandations,
-Accompagnement du district dans la mise en oeuvre des recommandations,
-Mise en place d’un système harmonisé de collecte des données communautaires incluant tous les paramètres de suivi de la MAS (base de données complémentaires)
-Augmentation des ressources humaines dans les centres de santé,
-Recherche d’un système de motivation des agents de santé des CSPS (FBR, primes) conjointement avec les districts.
Du District sanitaire de Gorom Gorom :
-Restitution formelle des résultats de la SQUEAC,
-Evaluation de la mise en oeuvre des recommandations de la SQUEAC dans les cadres de concertation périodiques,
-Renforcement de la concertation entre acteurs de mise en oeuvre du programme,
-Recherche d’un système de motivation des Agents de santé communautaire (ASBC),
-Renforcement des compétences des agents de santé (formation, supervision),
-Renforcement des ressources humaines des CSPS,
-Amélioration des connaissances des populations sur la malnutrition et le programme de PEC,
-Recherche d’un système de motivation des agents de santé des CSPS (FBR, primes),
-Recherche des moyens pour faire face aux barrières géographiques.
Le Croix Rouge de Belgique (CRB) et la Croix Rouge Burkinabè travaillent en partenariat avec le service de la santé depuis 2007 dans la région du Sahel au Burkina Faso. Ce partenariat est orienté vers le renforcement des capacités en ce qui concerne la Prise en Charge de la Malnutrition Aiguë sous financement ECHO. Aujourd’hui, le programme couvre les 13 CSPS dans le district du Sebba aussi que 23 CAPN (Centre d’Accueil Pour Nutrition). Le programme est actuellement en phase 6, phase ayant débutée en mars 2013 qui prendra fin en janvier 2014. Cette phase prévoit de consolider l’appui au système de santé de la région du Sahel en vue d’accroitre son efficacité dans la prise en charge ambulatoire de la malnutrition aigüe à travers des appuis techniques et financiers touchant à la fois la qualité, la couverture, le suivi/évaluation et la capitalisation de la prise en charge de la malnutrition aigüe.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Sebba:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/RAPPORT-SQUEAC-SEBBA.pdf
","","","","","","","International Committee of the Red Cross (ICRC)","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23213","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Sebba","Primary health care center","","Le cadre approprié pour la prise en charge de la malnutrition aiguë modérée est constitué des Centres de Santé et de Promotion Sociale (CSPS), des Centres Médicaux avec Antenne Chirurgicale (CMA) ou tout autre structure menant des activités de supplémentation alimentaire. En période d’urgence des Centres de Supplémentation Nutritionnelle (CSN) pourront être ouverts à cet effet.
Le cadre approprié de la prise en charge de la malnutrition sévère est le centre de récupération et d’éducation nutritionnelle (CREN). Son rôle principal est le traitement de la malnutrition sévère et l’éducation des familles en matière de nutrition. Là où il n’existe pas de CREN, les CSPS doivent assurer une prise en charge en externe des cas adaptés à ce mode de traitement.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du 1 au 20 novembre 2013 en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Points forts:
- Les ASC / AV sont actifs avec leurs activités
- Le CSPS est le premier recours aux soins
- Il existe une bonne connaissance et une appréciation du traitement ATPE.
Barrières à l’accessibilité des soins qui limitent la couverture:
- La distance et l’inaccessibilité géographique des certains villages, surtout en saison des pluies.
- La qualité de la prise en charge de la Malnutrition Aigüe Sévère au niveau CSPS : Pas de dépistage systématique aux cours des consultations, temps d’attente trop long, manque de communication entre les AS et les mères concernant le traitement, mauvais accueil au CSPS.
- Manque de connaissance de la malnutrition et du programme : les mères voient que l’enfant est malade mais ne savent pas de quelle maladie l’enfant souffre ni pourquoi. Elles vont au CSPS car c’est là où elles soignent les enfants malades mais pas parce qu’elles connaissent le programme.
En octobre 2012, Helen Keller International (HKI) a entreprit de mettre en oeuvre le programme de renforcement des activités de prévention et de prise en charge de la malnutrition aigüe à assise communautaire dans le district sanitaire de Koutiala, dans la région de Sikasso. Les deux axes principaux du programme de HKI sont le renforcement des capacités des prestataires sanitaires dans 40 Centre de Santé Communautaire (CSCom) du district et la mobilisation communautaire dans 18 aires de santé. Le but du projet étant de renforcer les compétences des prestataires sanitaires et communautaires pour la prévention, et le traitement de la malnutrition aigüe.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Koutiala:
http://www.coverage-monitoring.org/wp-content/uploads/2014/01/Rapport-SQ...
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23245","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Koutiala","Community-based|Primary health care center","","Le but du projet étant de renforcer les compétences des prestataires sanitaires et communautaires pour la prévention, et le traitement de la malnutrition aigüe en faisant les actions suivantes:
- Formations des prestataires sur le protocole national de la PECIMA qui n’ont pas bénéficiés des dernières formations.
- Formation des prestataires à communiquer avec les mères des enfants sur les bonnes pratiques nutritionnelles à travers la promotion des Actions Essentielles en Nutrition.
- Formation sur le social BCC (Négociation pour le changement de comportement).
- Supervision formative au niveau des CSCom pour maintenir la qualité des services PECIMA offerts.
- Supervision formative Groupes de Mères dans le dépistage des enfants dans les communautés et la référence des cas vers les CSCom.
A Koutiala ces activités se sont traduites par:
- La formation sur le protocole National de 41 agents des CSCom et formation de 122 autres sur les Actions essentielles en nutrition et la communication.
- La supervision formative dans au moins 18 CSCom par mois cela depuis février 2013.
- La formation de 216 membres de groupes de mères pour le dépistage et la référence des enfants souffrant de malnutrition aigüe. Les groupes de mères ont à leur tour organisé des sessions de sensibilisation auxquelles 4687 mères ayant des enfants de moins de 5 ans ont participé.
- Les actions du projet ont aussi porté sur l’organisation de réunions de monitorage des activités PECMA regroupant tous les DTC (Directeur technique de Centre de santé) et l’équipe cadre du district. Au cours de ces réunions, en plus du monitorage, des sessions de formations sur les principales lacunes identifiées par le superviseur et sur les rapports furent tenues
Des réunions communautaires dans les CSCom ayant des groupes de mères ont été organisées dans 18 CSCom. Les principaux responsables des aires de santé ont participé à ces réunions, dont l’un des objectifs était de présenter le travail des membres des groupes de mères et solliciter l’appui des responsables des aires de santé dans la mobilisation communautaire pour le dépistage et la référence des cas de malnutrition aigüe.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du 24 novembre au 8 décembre 2013en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d’identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
La méconnaissance de la malnutrition a été ressortie comme première barrière a l’accès aux soins au cours des trois étapes de l´investigation malgré le nombre très élevé de cas de MAS dans le district. Ni les signes de la maladie -spécialement du Kwashiorkor- ni les causes ne sont identifiés. La manque de connaissance sur des aspects de prévention de la malnutrition est en lien avec l’insuffisance de sensibilisation et de communication pour le changement de comportement en matière de pratique de l’alimentation du nourrisson et du jeune enfant, un des points fondamentaux du programme nutrition de HKI.
Le dépistage n´est pas suffisant ni fait de façon routinière: il n´y a pas un dépistage actif régulier dans la communauté, seulement il est fait pendant la campagne de masse, même s´il y a des relais communautaires dans le village. Les GM sont plus actives mais les occupations les empêchent de le faire pendant tout l´année. Au niveau des structures de santé, le dépistage passif des enfants qui arrivent aux CSCom n´est pas systématique dans la plupart des centres. Les activités de dépistage sont essentielles compte tenu la sévérité de l´état des cas admis dans le programme, bien soit par la non reconnaissance de la maladie ou par des autres raisons soulevées comme l´utilisation de la médicine traditionnelle, la distance, les occupations des mères ou le manque de moyens financières. Le suivi des GM et les réunions périodiques avec les leaders communautaires sont essentiels pour diminuer les barrières à la couverture au niveau communautaire.
La problématique des abandons du programme, élevés et précoces, semble être en lien avec divers aspects du service qu´influencent l´opinion des bénéficiaires comme les très communs ruptures d´intrants - même si en termes d´intrants nutritionnelles les ruptures sont plus fréquentes pour le traitement des cas modérés (PPS), la population ne connait pas la différence entre les deux produits (le nom en langue local est le même). En fait la communication au niveau de l´URENAS entre le personnel et les mères est très faible. L´information sur la maladie, le traitement et le fonctionnement du service donnée aux accompagnants des enfants MAS est presque inexistante même quand le temps d´attente est souvent longue. Tous ces aspects appréciés par la communauté et liés à la qualité du service doivent être pris en compte sans oublier les autres faiblesses plus techniques identifiées, comme le non-respect du protocole et la sous notification des abandons, qu’influencent aussi la couverture.