"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" "8818","Improving nutrition of women and children: the MICAH program ","English","Multi-national","","ETH|GHA|MWI","Ethiopia|Ghana|Malawi","Ethiopia|Ghana|Malawi","Peri-urban","completed","01-1995","01-2005","
The MICronutrient and Health (MICAH) Program contributed to improved quality of life of women and children in five African nations (Ethiopia, Ghana, Malawi, Sénégal and Tanzania) over a 10-year period between 1996 and 2005. The problem of micronutrient deficiencies (vitamin A, iron and iodine) was addressed through integrated strategies and direct interventions that resulted in measurable positive effects. Quantitative and qualitative program results affirm the contribution of MICAH’s achievements towards the Millennium Development Goals, and global nutrition and health targets.
","http://www.wvnutrition.net/home/resources/better-practices/micah-final-d...
","8329|8270|8112|8488|8111|8013|8657|8369|7979|7917","","","","","","World Vision International","","","","","","","","","","","","","","Ethiopia • $4.4 million budget (USD, 2002-2005)Ghana • $745,000 budget (USD, 2002-2005)Malawi • $3.8 million budget (USD, 2002-2005)","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","Working in close cooperation with government, non-government organizations (NGOs), and communities, MICAH built on existing delivery systems within ministries of health, education and agriculture, equipping them to strengthen the coverage and quality of their mandated activities. The foundation for a self-sustaining nutrition and health infrastructure was laid, by empowering communities to take ownership for program activities within their grasp: exclusive breastfeeding, capacity building of community health workers in nutrition and health, establishment of household gardens and revolving funds, and latrine construction.
MICAH also provided education to local populations about the importance of health and nutrition. Thousands of community health workers and volunteers were trained while program staff were equipped with skills to monitor and evaluate the program, gathering valuable information to assess its impact.
","Ethiopia
Ghana
Malawi
ETHIOPIA
Supervision/monitoring visits were routinely made at all levels of Ethiopia’s MICAH projects.The program coordinating office and program partners conducted 86 visits to assess the implementation and progress of various initiatives.Throughout the year, activity reports and evaluation documents were reviewed, site visits made, and ongoing discussions held between MICAH staff and stakeholders. After every visit, copies of feedback reports were sent to the relevant ADPs and NGOs. At the project level, MICAH facilitators conducted joint field visits and reviews with frontline personnel such as government health workers, community health workers, volunteers and school teachers to ensure implementation of activities was proceeding according to plan.
GHANA
Monitoring of MICAH Ghana improved in several ways in Phase 2 as the program team worked closely with Ghana Health Service and community health volunteers. Increased effectiveness was best illustrated by the heightened accuracy of data for iodized salt consumption after changing the method from school-based to houseto-house surveys.The team reinforced this effort by testing the quality of salt in markets as well. To improve monitoring of compliance with iron supplementation, MICAH facilitators worked closely with community health volunteers to assess whether women and children were taking the supplements as prescribed.Throughout the program, monitoring information was shared with all stakeholders at quarterly district and sub-district meetings in an effort to improve implementation and build ownership.
MALAWI
Regular meetings were conducted with government ministry and partner staff to share feedback and resolve issues.Training was provided and follow-up maintained to improve the capacity of field agents and staff. Regular community visits, including meetings with women and local leaders, provided management staff an opportunity to ensure quality implementation. Specific issues were dealt with using results-based management. For example, to obtain a more accurate estimate of deworming coverage in Phase 2, the household listing register was introduced and utilized, to supplement data regarding the de-wormed child. As a result of this new system, household monitoring revealed the extent of infection and enabled appropriate follow-up.To monitor the quality of the flour fortification project, the Malawi Bureau of Standards (MBS) and Chancellor College labs analyzed premix produced at the Domasi Fortification Unit. Each test found the Domasi premix to meet all MBS requirements; recommended levels of iron were found in the flour, and flour samples were free from contaminants.
","Ethiopia (1.8 million beneficiaries); Ghana (150,000 beneficiaries); Malawi (272,391 direct beneficiaries, with indirect benefit extending to 4.7 million people)","x","","","","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","","","","","","","","","","","","","","","","","","","","","","","“The MICAH approach is a good and successful model for the Ministry of Agriculture. Given right training people are ready to follow new habits and change traditional attitudes – for example, by eating rabbits and drinking goat milk. MICAH has provided a learning area for agriculture to reduce hunger.” – Mr. Bbvumbwe, Malawi
""""""""The positive impact of MICAH on the
health of children is a motivation to
continue. With improved knowledge,
good health and nutrition practices will
be sustained with support from chiefs
and elders.""""""""
– Qualitative survey, Ghana
Aa a result of the MICAH program… our children are healthy, alert and active; they look
attractive and beautiful; children are not falling sick with malaria as frequently as they did in the
past; the frequency of diarrhea and intestinal worms has decreased; eye diseases have decreased
because of improved hygiene; the harmful health practices have now been dropped because of
the intensive education given by health workers; and severe malnutrition, blindness, measles and polio have decreased.”
– Focus group discussion, qualitative survey, Ethiopia
","English" "11460","Systems Approach to Improving and Sustaining Food Security in West Africa","English","Multi-national","","GHA|MLI|SEN|SLE","Ghana|Mali|Senegal|Sierra Leone","","Rural","on-going","01-2012","01-2017","
The project aims to improve the food security status of people living in poor rural communities in Ghana, Mali, Sierra Leone and Senegal. The project will work to increase the adoption of agricultural practices that promote sustainable livelihoods; improve the utilization of health food especially by women and children; and, increase the effectiveness and use of agricultural extension services. Specific activities include: training farmers on best animal husbandry practices, seed production, pest management and early disease detection; as well as the training of government rural extension service staff in planning, implementing, and monitoring projects together with the participation of local communities and farmers. The project is expected to reach around 45,000 subsistence farmers and their families and around 1,400 members of farmer associations and purchasing groups, as well as local agriculture authorities.
At the country level, World Vision Canada is working in partnership with local farm-based civil society organizations to implement this project.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZEn/F97D0F095CDFC78985...
","8013|8487|8206|8036|8594|8592|8505|8365|8405|8354","","","","","","World Vision International","","","","","","","","","","","","","","CAD 11,056,793","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11459","","Promotion of food security and agriculture","","","","Women of reproductive age (WRA)","","","Community-based","","Training farmers on best animal husbandry practices, seed production, pest management and early disease detection; as well as the training of government rural extension service staff in planning, implementing, and monitoring projects together with the participation of local communities and farmers
","The expected intermediate outcomes for this project include: Increased adoption of practices, in a gender equitable manner, promoting sustainable livelihoods by the people living in poor rural communities; improved utilization of healthy food in a gender-equitable manner and with a particular focus on children; and, increased use of agricultural services by people living in poor rural communities.
","","The project is expected to reach around 45,000 subsistence farmers and their families and around 1,400 members of farmer associations and purchasing groups, as well as local agriculture authorities.","","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "22995","TCH Together for Child Health","English","Community/sub-national","","KHM","Cambodia","Battambang","Urban|Rural","on-going","10-2012","09-2015","The TCH project will use a health system strengthening model utilizing policies, guidelines and training materials to build capacity of health managers, health facility staff, Village Health Support Groups and community members to deliver a package of evidence based maternal, child health and nutrition interventions. TCH is an extension to the 'Optimizing Growth and Development Potential of Young Children"" that was implemented in the same operational district. It will build on the lessons learned from OGDPYC as well as Jumpstart, IICSA and Spien Sokhapeap
Goal: Mothers and children under two years in the project area are healthy, well nourished and have increased access to MCH services, contributing to a decrease in maternal and child morbidity and mortality
","","","National Nutrition Strategy","","","","","World Vision International","World Vision Cambodia","","","","","","","","","","","","","","International NGOs","World Vision International","WV Australia","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","22994","","Management of moderate malnutrition","","","","Infants and young children|Pregnant women (PW)|Women of reproductive age (WRA)","0-59 months","Battambang, 23 Health centers, 239 villages","Community-based|Primary health care center","","1 Project Manager
5 Project Coordinators
","
","
LQAS for monitoring
Baseline and final evaluation
","354,403","17%","","Stunting under fives 20.8% Underweight under fives 19.3% Wasting under fives 10.4%","N/A","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "22997","IICSA Initiative for Integration of Child Survival in ADPs","English","Community/sub-national","","KHM","Cambodia","Phnom Penh|Kandal|Preah Vihear province|Kampong Thom|Battambang|Takeo","Urban|Rural","on-going","10-2010","09-2014","IICSA seeks to increase target communities knowledge and strengthen practices on maternal and child care, nutrition, hygiene and sanitation through improved capacity of target ADPs. The program will also help to strengthen the capacities of health care institutions and community partners to deliver quality health services and information to all families, especially pregnant and lactating women and parents with children under 2 years of age.
Goal: ADP staff are skilled and confident with the ability to work effectively with key partners to design, implement, monitor and evaluate maternal, child health and nutrition interventions, which will contribute to measurable reductions in child malnutrition and mortality.
","","","","","","","","World Vision International","World Vision Cambodia","","","","","","","","","","","","","","International NGOs","World Vision International","WV Australia","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","22996","","Management of moderate malnutrition","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)","-9 to 59 months","Kulen, Children of Hope, Ponleu Knong Chet, Ponhea LeuPrasat Ballang I, Prasat Ballang II, Prasat Sambo, Tbeng Meanchey, Rovieng, Sangkum Thmey, Phnom Prek, Banan, Samrong II, Chulkiri, Saang","Community-based|Primary health care center","","3 zonal health coordinators
1 Maternal Child Health Capacity Building Officer
1 Health and Nutrition Administrative Officer
1 M&E/Knowledge Management Technical Specialist
1 Senior Health and Nutrition Program Manager
","","
","359,110","15%","","Underweight of under fives = 23%Stunting of under fives = 28%Wasting of under fives = 9%","N/A","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","
","English" "23000","SKL Sahakkom Kon Laor - Child Well Being Community","English","Community/sub-national","","KHM","Cambodia","Phnom Penh","Urban|Rural","on-going","07-2013","06-2015","
SKL is an adaption of the Positive Deviance (PD) Hearth approach which is contextualized for communities in Cambodia, both urban and rural. It will leverage community mobilization and participatory learning in action to identify positive child care, feeding practices and resources from within the community for the identification and rehabilitation of moderately malnourished children. SKL is currently being implemented in urban slums of Phnom Penh as described below.
Goals:
","","8082","","","","","","World Vision International","World Vision Cambodia","","","","","","","","","","","","","","International NGOs","World Vision International","WV USA","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","22999","","Management of moderate malnutrition","","","","Infants and young children","0-59 months","Ponleu Knong Chet ADP","Community-based","","
1 Technical Officer
1 Project Coordinator
1 Nutrition Advisor
","Number and % of children 6- 36 months who achieved normal nutritional status after 1 year of graduating from SKL session
","
","English" "23002","chTIS Child Health Targets Impact Study","English","Pilot/research","","KHM","Cambodia","Siem Reap|Preah Vihear province|Kampong Chnang|Kampong Thom","Rural","on-going","07-2012","09-2016","
The chTIS will build an evidence-base to demonstrate programme effectiveness of WV's 7-11 strategy through a 2-arm quasi-experimental study focusing on assessment of the impact of a Core Intervention Package: timed and targeted counseling, Community Care Coalitions, Citizens Voice in Action
Goal: To measure and report on the effectiveness of World Vision's core 7-11 programming to improve and enhance child health around the world in a scientifically rigorous manner that will withstand peer-review.
","","","National Interim Guidelines for the Management of Acute Malnutrition","","","","","World Vision International","World Vision Cambodia","","","","","","","Research/academia","Johns Hopkins University Bloomberg School of Public Health; National Institute of Public Health","","","","","","International NGOs","World Vision International","WV Australia","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23001","","Management of moderate malnutrition","Breastfeeding, Complementary feeding and health system strengthening","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)","-9 to 59 months","Siem Reap, Preah Vihear, Kampong Chnang, Kampong Thom","Community-based|Primary health care center","","","Pregnancy
-ANC visits
-Proportion of women who were offered and accepted counseling and testing for HIV during most recent pregnancy, and received their test results
-Prevalence of anaemia in women of reproductive age
-Tetanus toxoid immunization
-Iron/Folate supplementation
-Food consumption
- Antihelminthic treatment
- Percent of pregnant women who slept under a LLIN the previous night
- Proportion of parents or caregivers practicing birth spacing
Birth
- Proportion of infants whose births were attended by skilled birth attendant
- Delivery at health facility
Postnatal
-Post birth wrapping
-Cord was kept clean and dry
-Breastfeeding practices: Immediate
-Breastfeeding practices: Exclusive
-Continued Breastfeeding
-Postnatal Care
-Care-seeking behavior
Birth to under five years
-Coverage of essential vaccines
-Proportion of parents or caregivers with children under 5 with presumed pneumonia who report that the child was taken to appropriate health provider
-Proportion of households where all children under five slept under a bednet (ITN/LLIN) the previous night
-Proportion of children who received correct treatment for malaria
-Hygienic practices
-Growth monitoring
-Complementary Feeding
-Vitamin A supplementation
-Anaemia
-Proportion of children given appropriate feeding during illness
-Proportion of young children receiving a minimum meal frequency
-Proportion of children consuming (daily) iron rich and fortified foods
-Proportion of children who received iron dose/tablet last week
-Proportion of children receiving minimum required food groups
-Prevalence of stunting in children under 5 years
-Prevalence of underweight in children under 5 years
-Prevalence of wasting in children under 5 years
","
","65,000","N/A","","Baseline report will be published around August 2014","N/A","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23027","SS Spien Sokhapeap - Bridges for Health","English","Community/sub-national","","KHM","Cambodia","Ksach Kandal","Rural","on-going","02-2011","09-2016","
SS will use a health system strengthening model utilizing the national health system, policies, guidelines and training materials to build capacity of health managers, health facility staff and community members to deliver a package of evidence based maternal and child health and nutrition interventions. SS will build on the experiences of Jumpstart and OGDPYC.
Goal: Mothers and children under two years in the project area are healthy, well nourished and have increased access to MCH and nutrition services, contributing to a decrease in maternal and child morbidity and mortality
","","22856","","","","","","World Vision International","World Vision Cambodia","","","","","","","","","","","","","","International NGOs","World Vision International","World Vision Canada","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23026","","Management of moderate malnutrition","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)","-9 to 24 months","Ksach Kandal","Community-based|Primary health care center","","1 Project Manager: ADP Health Coordinator
3 Project Assistants: Field Health Coordinators
% of pregnant women would have reported increase meals during last pregnancy
% of children 0-23 months put to the breast within one hour of birth
% of newborns who were not given any pre-lacteal feed
% of infants (0-5 months of age) exlusively breast-fed during past 24 hours
% of infants (6-8 months of age) who received solid, semi-solid or soft foods during previous day
% of children 6-23 months of age who received minimum meal frequency (two times for breasfed infants 6-8 months, three times for breastfed children 9-23 months and four times (including milk feeds) for non- breastfed children 6-23 months)
% of children 6-23 months of age who were fed with minimum dietary diversity (four or more food groups)
% of children 20-23 months who received breastmilk in the past 24 hours
% of children 6-23 months of age who were given increased fluids and continued feeding during illness (diarrhea) in last 2 weeks
% of mothers of children age 0-23 months who had four or more antenatal visits during last pregnancy
% of mothers with children age 0-23 months of age who received at least two tetanus toxoid vaccinations during pregnancy of the youngest child
% of mothers with children age 0-23 months of age who received at least two tetanus toxoid vaccination before or after the birth of the youngest child
% of mothers with children 0-23 months of age consumed at least 90 iron/folic acid tablets during last pregnancy
% of children age 0-23 months whose births were attended by skilled personnel
% of mothers with children 0-23 months of age consumed at least 42 iron/folate tablets during the first six weeks after the delivery of the youngest child
% of mothers with children 0-23 months of age consumed a dose of deworming medication within six weeks of the delivery of the youngest child
% of mothers with children 0-23 months of age consumed a dose of vitamin A capsule within 6 weeks of last delivery
% of mothers with children 0-23 months of age who received at least three post-natal visits from appropriate trained health workers within six weeks of the delivery
% of children 6-23 months received vitamin A capsule in the past six months
% of children age 12-23 months who consumed a deworming medication in the past six months
% of children 7-23 months who consumed 15 sachets of multi-micronutrient power during the last month
% of children age 6-23 months with diarrhea in the last two weeks who received oral rehydration solution (ORS) and zinc tablets
% of children age 09-23 months who have completed 3rd DTP dose plus measles vaccination
","
Mid-Term Evaluation
LQAS monitoring
","135,190","34%","","Stunting 31%Underweight 24%Wasting 10%","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23176","ACF-France programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Manni","English","Community/sub-national","","BFA","Burkina Faso","Manni, Burkina Faso","Rural","completed","05-2012","05-2014","Action Contre la Faim - France (ACF-F) intervient dans la région de l´Est du Burkina Faso depuis 2008 et dans la province de la Gnagna (le district sanitaire (DS) de Bogandé et Manni) depuis 2009. Le projet d’appui à la Prise en charge de la malnutrition aigüe (PCIMA) a commencé en mai 2012 puis reconduit en juillet 2013 et prendra fin en mai 2014 et a pour objectif de contribuer à la réduction de la morbidité et de la mortalité liées à la malnutrition aigüe. L’appui donné au district de Manni est fait depuis la Base d’ACF située dans le district de Bogandé.
","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 Manni (2013 and 2014):
","8806","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Government","Development","OFDA ( U.S. Office of Foreign Disaster Assistance)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23175","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Manni","Community-based|Primary health care center","","Les activités de prise en charge de la Malnutrition Aigüe (PCIMA) sont assurées dans tous les centres de santés du district sanitaire de Manni. Cela concerne aussi bien la prise en charge en ambulatoire (PCA) pour la MAS/MAM et la prise en charge en interne (PCI) pour les cas de MAS avec complications.
Les activités d’appui consistent essentiellement à la formation et au recyclage des agents de santé, les visites d’appuis techniques à travers des supervisions régulières pour la PCA et la PCI, appui en équipements médico-techniques et en intrants pour la prise en charge. Au niveau de la PCI ACF-F fait la subvention des repas des accompagnant(e)s depuis septembre 2012 ainsi que les soins médicaux (médicaments, consommables et examens biologiques) et évacuations des malades des CSPS vers les CREN.
","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.
","ACF effectue des évaluations périodiques de la couverture du programme PCIMA, la dernière évaluation a été réalisée en mai 2013. Pour voir l’évolution de la couverture et la mise en route des recommandations de l’évaluation passée, une seconde évaluation a été réalisée en février 2014, huit mois après la précédente évaluation qui avait montré un taux de couverture actuelle de de 26,1% [IC 95% : 17,1- 37,7%]. 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:
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
","La population du district sanitaire de Manni est estimee a 168 963 habitants en 2014 (RGPH 2006) dont les enfants de 6 a 59 mois representent 18,55% (31 343).","52,4% [IC 95% : 43,1 - 61,8%]","Point","Les prévalences selon l’indice Poids/Taille de la malnutrition dans la province de la Gnagna étaient estimées en septembre 2013 à 7,5% [5,8-9,6%] pour la Malnutrition Aigüe Globale (MAG) et à 1,2% [0,6-2,6%] pour la Malnutrition Aigüe Sévère (MAS).","","None","","","Others, please specify below","","Management","","Communication","","Infrastructure","","Others, please specify below","","","","","","","","","","","","","Les résultats indiquent une forte évolution de la couverture car elle est le double de celle retrouvée à la dernière évaluation. Cette situation est à mettre en lien avec une forte amélioration des activités de dépistages passifs au niveau des centres de santé ainsi que l’implication des animateurs communautaires pour la sensibilisation et la recherche des absents (personnels du GRET ONG partenaire qui se charge du volet communautaire). La disponibilité et l’implication des personnels surtout au niveau des CSPS pourraient être un point fort du district sanitaire ce qui contribue beaucoup à l’amélioration de sa couverture. L’absence des hameaux de culture, présents dans les autres districts sanitaires, notamment Bogandé, permet d’éviter les déplacements des populations pendant les périodes des récoltes, et serait grandement responsable pour cette forte couverture.
","","English" "23187","ACF-France programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Bogande","English","Community/sub-national","","BFA","Burkina Faso","Bogande, Burkina Faso","Rural","completed","05-2012","05-2014","Action Contre la Faim – France (ACF-F) intervient dans la région de l´Est du Burkina Faso depuis 2008 et dans la province de la Gnagna depuis 2009. Le projet d’appui à la Prise en charge de la malnutrition aigüe (PCIMA) a commencé en mai 2012 puis reconduit en juillet 2013 et prendra fin en mai 2014. L´appui donné au district de Bogandé est fait depuis la Base d’ACF située à Bogandé. Le projet actuel, financé par OFDA a pour objectif de contribuer à la réduction de morbidité et mortalité associées à la malnutrition aigüe au Burkina Faso.
","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 Bogande (2013 and 2014):
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Government","Development","Bureau du Foreign Disaster Assistance des États-Unis (OFDA) ","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23186","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Bogande","Primary health care center","","Les activités de prise en charge de la Malnutrition Aigüe (PCIMA) sont assurées dans les centres de santés publiques et confessionnelles du district sanitaire de Bogandé. Cela concerne aussi bien la prise en charge en ambulatoire (PCA) pour la MAS/MAM et la prise en charge en interne (PCI) pour les cas de MAS avec complications.
Les activités d’appui d’ACF consistent essentiellement à la formation et au recyclage des agents de santé, les visites d’appuis techniques à travers des supervisions régulières pour la PCA et la PCI, appui en équipements médico-techniques et en intrants pour la prise en charge. Au niveau de la PCI ACF-F fait la subvention des repas des accompagnantes depuis septembre 2012 ainsi que les soins médicaux (médicaments, consommables et examens biologiques) et évacuations des malades vers les CREN.
","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.
","ACF effectue des évaluations périodiques de la couverture du programme PCIMA, la dernière évaluation a été réalisée en mai 2013, dans la province de la Gnagna (District sanitaire Bogandé). Pour voir l’évolution de la couverture et la mise en route des recommandations de l’évaluation passée, une seconde évaluation a été réalisée en février 2014 (03 au 23 février 2014), huit mois après la précédente évaluation qui avait montré un taux de couverture actuelle de 30,2% [IC 95% : 20,8- 41,6%].
L' investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite 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.
","Les enfants de 6 à 59 mois représentent 17,85% (61736) du population du district sanitaire de Bogande","38,8% [IC 95% : 29,8 - 48,6%]","Point","","","None","","","Others, please specify below","","Management","","Others, please specify below","","Infrastructure","","Others, please specify below","","","","","","","","","","","","","Cette couverture faible est à mettre en lien avec les préoccupations des mères (charge de travail) ainsi qu’une méconnaissance de l’importance des soins nutritionnels (malnutrition perçue souvent comme maladie traditionnelle) entrainant un recours de première intention au traitement traditionnel, limitant ainsi l’accès aux soins en dépit de sa gratuité pour les enfants malnutris. L’investigation a par ailleurs mis en évidence une faiblesse du système de dépistage actif et de suivi des absents au traitement, ce qui pose la question de la pérennisation de ces activités en l’absence de soutien technique continu.
En plus de ces barrières à l’accessibilité communes dans l’ensemble du District Sanitaire de Bogandé, la distance est ressortie comme un frein supplémentaire à l’accessibilité dans les zones concernées.
Nonobstant ces barrières et la faible évolution de la couverture il faut rappeler que des efforts considérables sont mis en oeuvre sur le terrain par les différents acteurs dans le cadre des activités de PCIMA, tant au niveau communautaire que sur le plan de la prise en charge dans les structures de santé. Dans le contexte actuel et pour espérer un désengagement total d’ACF dans le District Sanitaire de Bogandé quant aux activités de prise en charge de la malnutrition, il apparaît aujourd’hui impératif d’entreprendre des mesures correctrices afin de consolider les acquis et continuer d’améliorer la couverture et l’accessibilité au traitement pour les malnutris.
","","English" "23192","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Diapaga","English","Community/sub-national","","BFA","Burkina Faso","Diapaga, Burkina Faso","Rural","on-going","03-2008","","ACF met en oeuvre depuis 2008 un programme d’appui à la prise en charge de la malnutrition aiguë dans le district sanitaire de Diapaga, s’articulant autour de plusieurs volets :
Au niveau du système de santé:
- Un volet d’appui technique et logistique aux formations sanitaires pour la détection et la prise en charge des cas de malnutrition aiguë sans complications dans 30 Centre de Santé et de Promotion Sociale (CSPS) et des cas de malnutrition aiguë sévère avec complications médicales dans 3 Centre de Renutrition et d’Education Nutritionnelle (CREN).
- Un volet « subvention des soins » garantissant une exemption de paiement pour les personnes souffrant de malnutrition aiguë (modérée et sévère) admises dans les structures. Un projet pilote visant à l’exemption totale de paiement pour tous les enfants de moins de 5 ans a par ailleurs été démarré en novembre 2011 dans les 5 aires sanitaires de la commune de Logobou.
Au niveau communautaire:
- Un système de détection, référencement et suivi des cas de malnutrition aiguë s’appuyant sur un réseau d’Agents de Santé à Base Communautaire (ASBC) co-animé en partenariat avec une ONG locale (APDC).
- Des activités de sensibilisation et d’éducation à la santé dans le but d’apprécier et et d’améliorer les performances du programme en termes de couverture et d’accessibilité.
","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 Diapaga (2012-2014):
http://www.coverage-monitoring.org/wp-content/uploads/2013/04/SQUEAC_BURKINA_Diapaga_2012.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23191","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Diapaga ","Community-based|Primary health care center","","","Des evaluations de la couverture ont été realisées chaque annee depuis le debut du programme. Celles-ci ont revele des niveaux de couverture actuelle globalement faibles (couverture 2010: 21,8% [IC 95%: 13,2%-32,2%], couverture 2011: 17,6% [IC 95%: 7,8%-31,6%], couverture 2012: 32,1% [IC 95%: 21,9%-44,4%], couverture 2014: 43,6% [34,2%-53,2%] ), avec cependant une progression relevee au cours de la precedente SQUEAC (Semi-Quantitative Evaluation of Access and Coverage).
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.
","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 population est estimee en 2013 a 444 852 habitants avec 18,32% d’enfants d’age compris entre 6 et 59 mois.","43,6% [34,2%-53,2%]","Point","Les prevalences de la malnutrition selon d’indice Poids/Taille en z-score dans la Region Sanitaire de l´Est etaient estimees en 2013 a 9,3%1(8,3%-10,4%) pour la Malnutrition Aigue Globale (MAG) et a 1,7% (1,3%-2,3) pour la Malnutrition Aigue Severe (MAS)","","None","","","Communication","","Management","","Management","","Others, please specify below","","Others, please specify below","","Communication","","Others, please specify below","","Communication","","","","","","","Le résultat de couverture montre une nette amélioration en quasiment deux ans. Malgré tout, des faiblesses « basiques » (prise du PB au mm, rapportage) identifiés dans les évaluations précédentes sont toujours d’actualité après 3 ans de programmes. Au niveau de la prise en charge de la MA au sein des structures de santé, on note une réelle difficulté d’appropriation et de pérennité. Les activités liées à la prise en charge intégrée de la malnutrition aigue sont souvent perçues comme une charge de travail supplémentaire, et non intégrée au travail quotidien du centre de santé. Ceci peut entrainer un manque d’intérêt de la part des agents de santé, et une difficulté dans la collaboration avec les équipes ACF, ce qui est un frein à la pérennité une fois ACF parti. Un réel travail doit être fait conjointement avec l’ECD afin de pouvoir changer ces perceptions au niveau communautaire, on note que les barrieres sur la connaissance de la communaute sur la malnutrition restent presentent apres plus de 3 ans de programme NAC (Etude Causale de la malnutrition). L’approche NAC doit etre remise en cause avec une plus forte integration des agents de sante et des relais communautaires (ASBC) afin d’en assurer la perennite et un plus fort impact.
","","English" "23194","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Fada N’Gourma","English","Community/sub-national","","BFA","Burkina Faso","Fada N’Gourma, Burkina Faso","Rural","on-going","08-2012","","ACF à travers le programme nutrition santé appuie le DS de Fada à la prise en charge de la malnutrition aigüe depuis août 2012 suite à la crise alimentaire de 2012 au sahel. Ces appuis se font par le renforcement des capacities à travers les formations, les dotations de matériels médico techniques, la subvention des évacuations et des soins médicaux, et des visites d’appuis techniques lors des séances de prise en charge. Au niveau communautaire, ACF travaille en partenariat avec le GRET qui mène des activités de sensibilisations, de dépistage, de Visite à Domicile (VAD) à travers des animateurs.
","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 Fada N’Gourma:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/ACF-SQUEAC-BF-GOURMA-2014-VF.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Government","Development","L’Agence Suédoise de Développement International (ASDI)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23193","","Management of severe acute malnutrition","","","","SAM child","Enfants de 0 à 59 mois","District de Fada N’Gourma","Community-based|Primary health care center","","Les interventions concernaient au départ deux communes à savoir Matiacoali et Diabo. En mai 2013, l’appui d’ACF au district s’est étendu à l’ensemble des 6 communes dans les 39 Centre de Santé et de Promotion Sociale (CSPS), le CHR et le Centre de Récupération et d’Education Nutritionnelle (CREN) confessionnel toujours avec un financement d’ASDI. Le programme appuie régulièrement le district dans la prise en charge. ACF assure également une approche NAC (Nutrition à Assise Communautaire) à travers son partenaire Groupe de Recherche et d’Echange Technologique (GRET) qui intervient dans le DS de Fada depuis 2009.
","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 15 janvier au 11 février 2014 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.
Les analyses quantitatives et qualitatives ont revele un nombre relativement important de points d’attention en terme de depistage, acces et qualite de soins, freins et pesanteurs socioculturels, difficultes de notification des cas, qui, sans enlever l’appreciation positive de ce resultat meritent neanmoins le renforcement de l’accompagnement des activites de PeC dans le district.
L’implication communautaire: insuffisance de communication des ICP avec les ASBC et faible motivation des ASBC, faible implication des autorites et des leaders dans la PeC, faible interet des hommes dans la sante des enfants…
L’organisation des activités communautaires: bien que la population soit informee du role des ASBC au sein de la communaute, il y a une insuffisance de connaissance sur la malnutrition, le programme de prise en charge. Il devient donc important de revoir l’approche de sensibilisation communautaire pour en ameliorer l’impact et assurer une meilleure implication des agents de santé communautaire.
Les dysfonctionnements au niveau de la prise en charge: long temps d’attente, rejet ou limitation du nombre de cas PeC par jour, mauvais accueil, l’insuffisance de depistage systematique en consultation curative …
Les facteurs socio-culturels, notamment pour le recours aux soins, le refus de certains maris ou des interdictions faites aux meres, le recours a la geomancie, les pratiques ancrees nefastes.
L’occupation des mères: Travaux menagers, travaux champetres, faible implication des hommes…
Les problèmes de distance, d’enclavement ou d’eloignement temporaires dans les hameaux de culture, s’ils n’ont pas ete demontres comme un facteur determinant a la couverture (voir resultats de la petite enquete), peuvent avoir un impact sur la qualite du service, notamment au niveau de la gestion des intrants, et de la disponibilite des agents de sante. En effet, la fluctuation des admissions ne permet pas aux agents de santé d’évaluer correctement les quantités d’intrants nécessaires par mois.
Tous ces facteurs ont un impact négatif sur la fréquentation des services de PCIMA et méritent de se pencher sur l’amélioration de :
- La régularité et la qualité des dépistages
- La qualité de l’accueil et de la PCIMA
- L’identification et la recherche précoce des absents ou abandons
- Les méthodes de communication pour les changements de comportement en pratiques de soins
- La coordination des activités des ONG.
Pour assurer les activités de Prise en charge Communautaire de la Malnutrition Aiguë (PCMA), le DS de Pama bénéficie d’un appui de l’ONG Action Contre la Faim-France (ACF-F), aussi bien pour la Prise en Charge Ambulatoire (PCA) que pour la Prise en Charge en Interne (PCI). ACF a marqué sa présence dans la Province en deux phases : 1) un appui à distance à partir de Fada de janvier à Août 2010 et de novembre 2010 à novembre 2011, et 2) l’implantation d’une base à Pama à partir de Mai 2012 avec un personnel permanent sur place. Entre temps, l’ONG a suspendu ses interventions dans la province d’août à novembre 2010 et de novembre 2011 à mars 2012 suite à un manque de financement. Pour un besoin de pérennité, ACF intervient dans le district sanitaire en partenariat avec une ONG locale, TIN TUA (""développons-nous nous-même""). Elle conduit les activités de Nutrition à Assises Communautaire (NAC): mobilisation communautaire, conduite des campagnes de dépistage et de sensibilisation en collaboration avec le DS et implication des leaders communautaires et collectivités.
","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 Pama:
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23209","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Pama","Community-based|Primary health care center","","Le DS de Pama compte 11 Centres de Santé et de Promotion Sociale (CSPS) normalisés, un Centre Médical avec Antenne chirurgicale (CMA) avec en son sein un Centre de Récupération et d’Education Nutritionnelle (CREN). Le District met en oeuvre le Paquet Minimum d’Activités (PMA), et la prise en charge de la malnutrition aigüe est assurée dans toutes les formations sanitaires.
Pour un besoin de pérennité, ACF intervient dans le district sanitaire en partenariat avec une ONG locale, TIN TUA (""développons-nous nous-même""). Elle compte 9 facilitateurs communautaires installés dans les trois communes de la province de la Kompienga et d’un coordinateur des activités terrain qui supervise les activités.
","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 19 Juin au 02 Juillet 2013en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). Cette investigation intervient 6 mois après la SQUEAC précédente (novembre-décembre 2012) qui avait abouti á une couverture de la période de 40,6% (IC 95%: 28.9 - 54.2). 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.
Au niveau des facteurs qui influencent de façon négative la couverture, l’insuffisance d’informations données aux populations sur la prise en charge, la méconnaissance des signes et des causes de la malnutrition continuent à être les barrières principales identifiées au cours de cette SQUEAC comme l’a déjà été lors de l’investigation de décembre 2012. En plus une nouvelle importante barrière a été identifiée : la stigmatisation (mères avec enfants malnutris). Certaines mères avec enfants MAS sont enceintes et le fait d’avoir eu des naissances rapprochées constituent une honte aux yeux des populations. Par ailleurs les naissances rapprochées ont été identifiées par la communauté comme cause la MA ou appellation du marasme.
Dans les facteurs qui influencent de façon positive la couverture, la bonne opinion de la PCA à travers les guéris MAS qui sont dans la communauté et le dépistage actif trimestriel réalisé par le district avec ses partenaires sont des booster importants signalés dans la SQUEAC. En plus l’admission par le PB pour les moins de 65 cm n’est plus une barrière. En effet seul l’âge de 6 mois est désormais considéré pour les admissions par le PB.
","","English" "23232","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Danané","English","Community/sub-national","","CIV","Côte d'Ivoire","danané, cote d'ivoire","Rural","on-going","03-2011","","ACF a démarré en mars 2011 un programme d’appui au district sanitaire de Danané pour la mise en oeuvre de la PCIMA. Ce programme, débuté dans le cadre de la crise humanitaire consécutive aux violences post-électorales dans l’Ouest de la Côte d’Ivoire, est progressivement passé d’un mode opératoire de «substitution» - justifié par les importants dysfonctionnements du système de santé au plus fort de la crise – à un accent mis sur l’intégration de la prise en charge dans le système de santé existant.
","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 Danané:
http://www.coverage-monitoring.org/wp-content/uploads/2013/02/Ivory_Coats_Danan%C3%A9_Nov_2012.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23231","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Danané","Primary health care center","","Ce programme, initié pendant la période de post-crise immédiate, a d’abord été mis en oeuvre dans 6 aires sanitaires pour la prise en charge des cas MAS en ambulatoire et au niveau de l’hôpital de Danané pour la prise en charge des cas MAS avec complications au niveau de l’UNT. Le programme a ensuite été progressivement étendu jusqu’à couvrir la totalité des aires sanitaires du district (17 structures de santé).
","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 06 au 29 novembre 2012 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.
Au total, cette faible couverture est le reflet de l’impact particulièrement négatif des ruptures en intrants nutritionnels sur l’accessibilité au service. Outre le défaut de prise en charge des cas MAS admis dans le programme, les ruptures d’ATPE répétées et prolongées contribuent en effet à renforcer l’effet des autres barrières à l’accessibilité telles que la distance et les difficultés d’accès géographique, l’indisponibilité des mères pendant la période des travaux agricoles, ainsi que la barrière financière liée aux coûts de transport et aux éventuels frais liés à une consultation. Au niveau des structures de santé, l’absence d’intrants ne permet pas aux agents d’assurer une prise en charge adéquate des cas MAS, entraînant des insuffisances dans la qualité de la prise en charge et une démotivation des agents (sous-notification des abandons, quantité d’ATPE délivrée non adéquate, relâchement ou suspension des activités de dépistage passif).
Le faible niveau de couverture est également à mettre en lien avec la transition difficile entre le dispositif d’appui renforcé mis en oeuvre par ACF pendant la période de post-crise immédiate et l’intégration complète des activités de PCIMA dans le système de santé existant. D’importants moyens ont en effet été déployés lors du démarrage des activités, avec un accent particulier mis sur les activités de sensibilisation et le système de dépistage. Ces efforts ont amélioré la compréhension de la malnutrition dans la communauté et ont permis de traiter un grand nombre de cas : le programme apparaît aujourd’hui bien connu et très apprécié. Les activités communautaires ont cependant connu un relâchement au cours des derniers mois suite à la diminution des modalités d’appui aux ASC, responsable d’une importante démotivation. L’investigation a par ailleurs révélé l’existence d’insuffisances au niveau du monitoring des activités communautaires, ne permettant pas un bon suivi. L’efficacité du volet communautaire apparaît pourtant particulièrement cruciale dans un contexte encore marqué par une méconnaissance de la maladie et un recours de première intention à la médecine traditionnelle.
","","English" "23234","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Toulepleu","English","Community/sub-national","","CIV","Côte d'Ivoire","Toulepleu, cote d'ivoire","Rural","on-going","05-2011","","A la suite de Danané et Zouan Hounien, ACF a démarré en mai 2011 un programme d’appui au district sanitaire de Toulepleu pour la mise en oeuvre de la PCIMA. Le programme, démarré sous forme d’équipes d’ Unité Nutritionnelle Thérapeutique Ambulatoire (UNTA) mobiles, est progressivement passé d’un mode opératoire de «substitution» - justifié par les importants dysfonctionnements du système de santé au plus fort de la crise – à un accent mis sur l’intégration de la prise en charge dans le système de santé existant.
","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 Toulepleu:
http://www.coverage-monitoring.org/wp-content/uploads/2013/02/SQUEAC_Rapport_Toulepleu_RCI_2012.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23233","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Toulepleu","Community-based|Primary health care center","","Les cas MAS sans complications sont pris en charge en UNTA au niveau des 8 Etablissement Sanitaire de Premier Contact (ESPC). Une UNT a été ouverte récemment (en octobre) au sein de l’hôpital général pour la prise en charge des cas MAS avec complications, qui jusqu’alors devaient être transférés vers l’UNT de Zouan Hounien. Les intrants thérapeutiques sont fournis par l’UNICEF. Un volet Centre de Nutrition Supplémentaire (CNS) existe également dans les 8 ESPC pour la prise en charge des cas de malnutrition aigüe modérée (MAM), appuyé par le PAM. Outre le support aux structures de santé, ACF a également développé des activités à base communautaire: celles-ci ont pour but de dépister et référer les cas de malnutrition aigüe et de diffuser des messages de sensibilisation et de prévention.
","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 6 au 19 novembre 2012 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.
Other lessons learnt
La régularité de l’approvisionnement en ATPE et l’impact du volet communautaire ont ainsi été relevés parmi les facteurs ayant favorisé une bonne accessibilité.
Malgré des constats encourageants, la couverture est apparue plombée par un certain nombre de barrières. Il s’agit notamment :
- au niveau district et central, de l’insuffisance de la clarification des critères d’entrée et de sortie du programme, de la faible supervision des activités des centres de santé et du volet communautaire ;
- au niveau des structures de santé, du manque d’implication du personnel de santé pour les activités de nutrition tant au niveau des centres de santé que dans les communautés de l’aire de santé, ce qui se traduit par un recrutement des cas non optimal ;
- au niveau communautaire, des contraintes financières, des longues distances à parcourir pour se rendre au centre de santé, l’enclavement de certains villages et campements et enfin de l’insécurité chronique dans la zone ;
Dans le contexte actuel de pérennisation des activités de PCIMA, la question d’une plus grande implication du personnel de santé et celui du renforcement du volet communautaire constituent des enjeux essentiels en vue d’une amélioration de la couverture et de l’accessibilité au traitement.
","","English" "23244","ACF-Espagne programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Kita","English","Community/sub-national","","MLI","Mali","kita, mali","Rural","on-going","07-2012","","Action Contre la Faim Espagne (ACF-E) met en place un programme de renforcement des capacités de prise en charge de la malnutrition aiguë dans tout le cercle sanitaire de Kita depuis juillet 2012 (une partie seulement du cercle était couvert depuis 2011). La prise en charge de la malnutrition aigüe sur Kita se fait au niveau du CSRef (Centre de santé de référence, situé à Kita) pour les enfants MAS avec complications (en URENI), au niveau des CScom (centres de santé communautaires) pour les enfants MAS sans complications (en URENAS) et MAM (en URENAM). Il est aussi à noter que des Agents de santé communautaire (65) ont été formés en 2012 au dépistage et à la prise en charge de la MAM.
ACF-E supporte techniquement et logistiquement les autorités sanitaires pour le dépistage et la PEC de la malnutrition aigüe sur toutes les aires de santé fonctionnelles du cercle de Kita à travers 2 projets: un financé par ECHO depuis 2012 (35 CScom) et un autre nommé PASAN, financé par AECID depuis 2011 (6 CScom8) et pour lequel ACF-E est en appui à une ONG nationale (Stop Sahel).
","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 Kita:
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","Spanish Agency for International Development Cooperation (AECID)","Bilateral and donor agencies and lenders","Other","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23243","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Kita","Primary health care center","","Le District sanitaire de Kita est constitué de 46 aires de santé. 3 sont toujours considérés comme non fonctionnelles6 (Kolé, Niantasso, Sanko). L’aire de santé de Sibikily vient d’être dotée en personnel et ACF-E leur a fait une formation sur la PEC de la 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 en decembre 2013 en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). Une première évaluation de la couverture du programme nutritionnel a été menée en mars 2013 et montrait des taux de couverture actuelle de 24,9% [IC95% : 14,5%-39,2%]. 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.
Au total, cette investigation met en avant le besoin de poursuivre le travail entrepris par les équipes d’ACF-E en collaboration avec les autorités sanitaires, le personnel des CScom et les relais communautaires. L’implication des ASC dans la PEC de la MAS est à envisager.
L’hypothèse d’hétérogénéité de la couverture a été confirmée, avec des zones de plus haute couverture dans les villages proches des CScom (<5kms) où des RC mènent des activités de dépistage et de sensibilisation et des zones de plus faible couverture dans les villages éloignés des CScom, d’autant plus si peu de dépistage des enfants malnutris aigus est effectué.