"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" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","
From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010The FMOH has developed a four-pronged national strategy for PMTCT: primary prevention of HIV infection; prevention of unintended pregnancies among HIV-positive women; prevention of HIV transmission from infected women to their infants; and treatment, care, and support of HIVpositive women and their infants and families. All health centers have a system of identifying infants born to HIV-positive mothers as part of their PMTCT program. 11The following is a brief description of the flow of PMTCT services, commencing from a woman’s first visit for ANC:All women coming for ANC are routinely informed—individually or in a group—about the benefits of HIV testing for mothers and babies. During this process—known as providerinitiated HIV counseling and testing—mothers reserve the right to say “NO.” Those who say “YES” will be tested.Women with positive results are referred to MSG mentors, and ANC follow-up continues. Their partners will also be tested.MSG mentors counsel an HIV-positive woman and transfer her to the ART nurse for antiretroviral drugs.The ART nurse takes a CD4 count. If not eligible for treatment based on her count, the woman will commence treatment and ANC follow-up continues. If she is eligible for treatment based on her count, she will be put on complete antiretroviral prophylaxis that starts at 27 weeks of gestation.Follow-up continues and the mother is advised to deliver at a health facility.At delivery, the infant will be started on prophylaxis as an HIV-exposed infant.A dried blood sample will be taken from the infant for polymerase chain reaction (PCR) testing after 45 days.Follow-up continues until cessation of breastfeeding, with re-screening done six weeks later.
","CD4 countsPCR test for HIV status of iinfant
","","x","Highly HIV prevalent regions","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","","Aberash, a 33-year-old woman, was in the 36th week of her pregnancy at the time of this assessment. She was not married and had tested HIV positive. Since the time she had learned her HIV status, Aberash had been visiting the health center in Shashemene at least once every week—and sometimes more often. Her primary concern was transmitting HIV to her unborn baby. Sr Terunesh*, the nurse responsible for ANC services at the health center, had been counseling Aberash on a number of issues related to her well-being and that of the baby. These discussions usually included nutrition-related issues, specifically breastfeeding and its potential hazards. In addition to these counseling sessions, Sr Terunesh had connected Aberash with the MSG for continued support, counseling, and encouragement, both from the mentors and from other mothers in the group.* Not her real name.
","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010Trials for Improved Practices (TIPs) is a relatively new and innovative methodology for Ethiopia, especially its use in shaping critical strategies to improve IYCF behaviors. The standard approach to TIPs implementation involves three household visits. The purpose of the first visit is to learn about current household feeding practices. The second visit is a ―counseling visit,‖ which includes the negotiating of a new practice with the mother or caregiver for her to try. The third visit is a follow-up visit to check on the mother’s experience in implementing the recommended/negotiated new practice. This ―negotiation TIPs‖ is mainly used in maternal and infant feeding, and identifies the best choices among a number of different actions that could yield IYCF nutrition benefits.
","Urban garden household participationFoods most frequently consumedHouseholds consuming at least four different food groups on a daily basis
","","x","Two similar, poor, urban populations from two districts (Adama and Debra Zeit)","","","","Socio-economic status","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","The results point to some specific areas that appear to be the most promising for improving complementary child feeding practices across the different age groups from 6 to 24 months:Improving the porridge/special food given to the child by adding different foods to enhance the quality and increase the energy density;Adding different mixtures to the porridge or giving different food combinations such as egg and potato;Adding fruits to the child’s diet, bearing in mind economic constraints that limit availability of fruit on a daily basis;Trying to introduce vegetables earlier, starting after six months and continuing (when mothers tried adding vegetables they found that their fears of ―doing harm‖ to the child were not justified); Increasing the amount of food provided in part by adding additional foods (fruits and vegetables); andUsing a separate bowl/plate for the child to facilitate monitoring the amount of food the child consumes.
","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Promotion of handwashing or hygiene interventions was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Promoting and implementation of delayed cord clamping was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing>>>Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing>>http://www.who.int/elena/titles/cord_clamping","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: Emergency Nutrition Intervention Guideline, August 2004
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: Protocol for The Management of Severe Acute Malnutrition, FMOH, March 2009
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010SamplingStudy participants were drawn from 45 communities in the nine project districts. The communities were selected based on the presence of mother support groups and church-based groups. In each district, purposeful sampling was used to select the female caregivers.1 The criterion used for selecting female respondents was that they were caregivers of children 6-24 months. Fathers2 of children 6-24 months, health workers, and community group leaders were selected using convenience sampling. Data collection methodsBoth qualitative and quantitative methods were used to conduct this study. Data were collected using a structured survey, in-depth interviews, and focus group discussions (FGDs) (see Appendix 2 for the study tools). Findings from all three sources were triangulated for the purpose of validation.Structured surveyEach study community was divided into six sub-areas, and one caregiver was selected from each sampled household within each sub-area, for a total of six participants per community.3Households in the cluster were numbered, and one was randomly selected. In a sampled household where there was more than one caregiver for the child aged 6-24 months, data collectors purposefully sampled for the interview one mother or caregiver who regularly fed the index child. In a situation where the selected caregiver had more than one child aged 6-24 months, the older one was selected as the index child. In-depth interviewsBased on the classification of health facilities in Brong Ahafo Region, we identified and selected four categories to use in the data collection exercise: district hospitals, clinics, health centers, and Community-Based Health Planning and Services compounds. In each district, five health workers were interviewed, including two health workers from the district hospital responsible for child welfare clinics (growth monitoring sessions) and one from each of the other three facility categories. Leaders of mother support groups and church-based groups at the community level whose activities could impact infant and young child feeding practices were also interviewed. In each district, five of these groups were randomly selected from a list of such groups within the district. Identification and sampling of the groups was done with the help of district-level health staff.
","From October 2010 to December 2011, the project:•Aired 855 radio spots with key messages on complementary feeding on Radio BAR, Omega FM, Success FM, Jerryson FM, Chris FM, Adarz FM, Star FM, and Royals FM. An additional 340 spots are scheduled to air in January 2012.Distributed 5,860 posters with key messages.Distributed 19,428 flyers with key messages.Trained 196 health workers and 137 community group leaders in appropriate complementary feeding practices and the use of BCC materials. Reached around 2,500 community group members with appropriate complementary feeding messages through trained group leaders.
","","45 communities in 9 selected districts in Brong- Ahafo region","45 communities in 9 selected districts in Brong- Ahafo region (","","Initiation of complementary feeding; Frequency of feeding; Feeding a variety of foods to children 6-24 months; Knowledge of three food groups; Caregivers who followed the World Health Organization’s (WHO) recommended practice of starting complementary foods at 6 months; Caregivers who gave fortified complementary foods to their children aged 6 to 9 months two or more times per day; Caregivers who gave their children aged 6 to 9 months porridge thick enough to stay on a spoon.","","Socio-economic status","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","Engaging District Health Management Teams is integral to success. IYCN and partners engaged district heads early in the process. As a result, they demonstrated strong support for the activities and they are poised to monitor the community-level activities to ensure effective rollout, dissemination, and distribution of BCC materials.Partnerships can help to expand reach. By collaborating with the BCS Project and leveraging a national behavior change communication campaign, the project was able to expand reach of the complementary feeding messages. Although the social marketing strategy targets the Brong Ahafo region, radio spots and BCC materials will be spread across the country as part of the Healthy Eating for Good Life campaign. Local partners at the district level, such as World Vision Ghana, also carried messages into districts outside of the project’s target area.Job-aids are necessary in communicating behavior change messages. Health workers in the target districts welcomed posters and leaflets that contained key messages and were grateful for them. It certainly made work easier for them. Since the orientations, community workers have displayed posters on walls in vantage points in all the communities and caregivers discussed the contents of the leaflets at community meetings.
","In addition to breastmilk, we give local dishes like palm nut soup with soya beans, banku and groundnut soup, fufu with soup, kontomire [cocoyam leaf] with soya beans, and fish soup. We also give them oranges and pineapple — FGD with women Sunyani West District.At weighing, we are taught how to dress the child, breastfeeding, cleanliness, sleeping under mosquito nets, and family planning, how to feed the child. — FGDs with women Jaman South and Sunyani West Districts“I learned a lot of things here. You see my son likes the breastmilk and the only other thing he will eat is porridge; so I am going to read this leaflet so that it will guide me on what to feed him. You see he is my firstborn so his health is important to me.” —Nursing mother“This project is a good start of what we want to see in the community; that the caregiver is empowered to be in charge of the health and good development of their children. What I would also like to see is strengthening the skills and competencies of the health providers so that [they] would be able to help caregivers do appropriate feeding especially for the children under two years.” —Mrs. Wilhelmina Okwabi, Deputy Director of Health Services (Nutrition)“I was part of the data collection process and listening to the preliminary results gives me a sense of ownership; also the results show what is happening in the district and it shows us the work we are doing in the districts. We’ve learnt a lot here. We are going back to educate the mothers on what they are not doing well and encourage them to continue the good feeding practices.” —Technical officer, Vivian Dapaah District“We are thinking of ending malnutrition in children in line with Millennium Development Goal 4. If we don’t feed them well we cannot achieve this. That is why this [IYCN] project is very important and timely for the Regional Health Directorate.” —WS Supiimeh, Regional Health Promoter
","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","","","","","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","","","","","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","","","","","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","Urban|Rural","completed","01-2006","01-2011","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010Study preparation and data collectionDue to the post-election violence that occurred in Kenya in January and February 2008, initiation of this study was postponed from its original start date of January 2008 to May 2008 to ensure the safety of the field team. The study team for Western Province included one field supervisor and four research assistants who were fluent in the local Luhya and Swahili languages. The study team for Eastern Province included one field supervisor and four research assistants who were fluent in Kamba, Swahili, and Kikuyu. A data analyst was also hired to enter and clean data in real time, as well as to assist with data analysis. Study procedural training was held with the entire study team, led by Dr. Kiersten Israel-Ballard and Ms. Margaret Waithaka, May 19–23, 2008. This included pretesting the data collection tools, revising all translations as needed, and piloting them in multiple languages at a local clinic. The study launch was on May 26 for Eastern Province, with field support from Dr. Israel-Ballard, and June 2 for Western Province, with field support from Ms. Waithaka. The data collection tools utilized in this study are available upon request.Study populations and proceduresThis cross-sectional study was designed to collect formative research data in a descriptive manner. This study took place at APHIA II (AIDS, Population and Health Integrated Assistance [USAID-funded program]) affiliated sites in the Kakamega, Vihiga, Hamisi, and Bungoma Districts of Western Province and in the Kitui, Makueni, Kibwezi, Machakos, Mwala, Yatta, Mwingi, and Mbooni Districts of Eastern Province. These regions were selected to include food-secure areas of Western Province and food-insecure areas of Eastern Province. Data collection occurred between May and September 2008. According to the 2007 Kenya AIDS Indicator Survey, Eastern Province had an HIV prevalence of 4.7 and Western Province of 5.1.This study was composed of a convenience sample of quantitative in-depth interviews, brief post-counseling exit interviews, and counseling session observations. A total of 386 women older than 18 years of age were recruited. In-depth interviews were conducted with 285 women (137 in Eastern Province, 148 in Western Province). Women known to be HIV positive were recruited from PMTCT clinics, comprehensive care centers, and postnatal wards at local clinics and referral hospitals, as well as from support groups affiliated with the health centers. Inclusion criteria included being HIV infected, having an infant <18 months of age, and having stopped breastfeeding between 1 week to 6 months prior to participation. Survey questions focused on the period over which breastfeeding cessation took place, including the age of the infant, liquids and foods fed during this period and their associated costs and availability, infant illness, breast health, general challenges, as well as a 24-hour dietary recall to capture current infant feeding practices and challenges. Infant weight and mid-upper arm circumference (MUAC) were measured to capture current nutritional status.Post-counseling exit interviews were conducted with 80 women (50 in Eastern Province, 30 in Western Province) who had not participated in the cross-sectional survey. The difference in sample size between provinces was due to clinic staffing shortages, resulting in the lack Kenya Infant Feeding Assessment 5 of individual postnatal counseling in Western Province; group PMTCT counseling was more commonly practised Women known to be HIV positive were recruited upon leaving an antenatal or postnatal PMTCT counseling session at a health facility. Inclusion criteria included being HIV positive, being pregnant, or having an infant <12 months of age. Counseling session observations occurred 22 times with different women and in various clinics (9 in Eastern Province, 13 in Western Province). Inclusion criteria included being HIV positive, being pregnant, or having an infant <12 months of age. In Eastern Province, four of these observations were antenatal and five were postnatal; in Western Province nine were antenatal and four were postnatal. Antenatal mothers were recruited in the antenatal care (ANC) clinic in the PMTCT section. Postnatal mothers were recruited in the comprehensive care center or in the maternal and child health (MCH) ward. Three observations were of ANC group counseling sessions rather than individual sessions; two in Western, one in Eastern. The observer used a check list to indicate whether a specified topic had been covered during the session. Although recruitment criteria were inclusive of both antenatal and postnatal mothers with infants under 12 months of age, most (n = 8) of the mothers interviewed postnatally had infants of only 1 month of age, while one mother had a 3-month-old and another had a 9-month-old infant, thus limiting the infant age ranges. All clients who met the recruitment criteria and consented to join the study during the recruitment period were recruited. To ensure eligibility and guardianship of the infant we required identification documents prior to enrollment. Additionally, 11 local stakeholders, including district and provincial nutritionists and nursing officers from Nairobi and Eastern and Western Provinces, were informally interviewed to gather their perceptions and attitudes toward infant feeding in the context of HIV in their communities.
","Weightfor-age (WFA) z-score,Upper-arm-circumference-for-age z-scoreMUACcount of the number of morbidities (0 to 5) the infant experienced during or subsequent to weaning, chosen from a list of five morbidities (respiratory symptoms, diarrhea, dehydration symptoms, fever, and refusal to eat)
","To monitor the progress of infant feeding and HIV activities, IYCN provided reporting tools which included a form to help APHIA II Western-supported PMTCT counselors accurately report on their facility-based activities in a standardized way, and to provide an opportunity to share successes and challenges; an observation checklist to provide structured feedback to facility-based counselors to improve their counseling and facilitation skills; and a reporting form for community-based workers to report on infant feeding activities. Subsequently, several PMTCT and HIV partners adopted the tools for use in their programs.
","*","Western and Eastern Province","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Confirming our post-counseling exit interview findings, we observed that few counselors discussed safe water as part of their AFASS assessment. Yet, this is a crucial factor for decision-making in this study population given that the most common water sources cited among mothers interviewed were rivers, dams, or open ponds. We also noted that the costs of replacement feeding were rarely mentioned. Interestingly, we observed more emphasis placed on risks from replacement feeding than on those from breastfeeding during ANC, but the opposite emphasis during postnatal visits, perhaps due to the perceived fear of infecting an otherwise healthy-looking infant. Regardless of when the counseling takes place, an accurate representation of risks and benefits associated with all infant feeding options needs to be conveyed to mothers. It was reassuring to note that most counseling sessions included discussion around how to stop breastfeeding, including mentioning that cessation should not occur until 6 months and that AFASS criteria should be in place, and providing an explanation of how a mother should physically stop breastfeeding (i.e., reduce number of breastfeeds per day) and how long the transition should take. However, as with the exit interviews, few mentioned manual expression to prevent breast pathologies. Although complementary foods were often discussed, mothers needed more detailed information on Kenya Infant Feeding Assessment 28 timing, frequency, quantity, diversity, and appropriate local foods to be able to optimally feed their infants. Although infants were often weighed, their growth progress was rarely discussed with the mother. Effective growth monitoring should also include growth promotion, which includes dialogue with the mother in order to identify and address problem areas before they lead to growth faltering or malnutrition.
","“I feel that those who fully understand/grasp the counseling are most likely to exclusively breastfeed.” - District Nursing Officer Western Province“If you take a mother through one-on-one counseling, most will then exclusively breastfeed successfully.” - District Nursing OfficerWestern Province
","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","Urban|Rural","completed","01-2006","01-2011","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: IMAM
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: intergrated management of acute Malnutrition
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010In Eastern Cape Province, IYCN supported PATH’s efforts to improve the quality, availability, and uptake of PMTCT services by strengthening under-resourced PMTCT sites and mobilizing communities to increase the uptake of those services. To prevent malnutrition and ensure HIVfree survival of children, IYCN contributed to integrating infant and young child feeding activities into PMTCT interventions. Specifically, the project helped develop atraining package for lay counselors and community health workers and supported the training of 100 community health workers on infant and young child feeding. In addition, the project assisted the provincial health department to develop tools for surveying facility-based nutritionservices.By adapting a regional, community-based planning tool for use locally, IYCN worked with private-sector partner, J & J Trust, South Africa’s Ekurhuleni Municipality, and Ward 86 within the municipality’s Nigel District to conduct a pilot program that integrated nutrition interventions into economic and community development planning. This model approach can be scaled up throughout the district and beyond to enhance awareness of the nutritional status of young children and dietary and feeding practices that can improve their health. Through this approach, IYCN trained community volunteers to engage the community in nutrition activities. The community response was overwhelming, and community leaders included nutrition activities in development plans. These new activities included establishing a support group for pregnant and lactating mothers and their parents and initiating an awareness campaign on available structures to support lactation.
","x
","","x","x","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","The use of existing structures and processes made planning community nutrition activities and allocating resources feasible. The community in Ward 86 continues to implement nutrition activities based on their community development plans. Although the project did not fund the implementation of these activities, community leaders were able to leverage existing structures and resources.Engagement with communities revealed that people are aware of nutrition and related issues, but that technical support is needed to develop creative behavior change interventions. It is possible to build better linkages between the community and health services by engaging the municipal planning system.
","“I have seen the level of interest in nutrition in the community increase, and now ward members are empowered to influence the development plans of the municipality and the district to prioritize support for nutrition.”— Benny Sikhakhane, IYCN Project consultant
","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Providing maternal supplements of balanced energy and protein was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "11466","Healthy Urbanisation: Tackling child malnutrition through intervening to change the social determinants of health in informal settlements and slums","English","Multi-national","","CHL|KEN","Chile|Kenya","Nairobi, Kenya|Mombasa, Kenya |Kisumu, Kenya|Valparaiso, Chile","Urban","on-going","01-2010","01-2013","The purpose of this project is to find out whether malnutrition in young children living in informal settlements and slums can be reduced through small-scale interventions operating to change the social determinants of health (SDH) through broadening participation. The SDH are a broad range of social and environmental factors operating at multiple levels of social organizations that can lead to inequities in the level and distribution of health and nutrition in a population.
This research will address the international poverty agenda through making a contribution to the first six of the eight Millennium Development Goals (MDG) for which adequate nutrition is a crucial input. It responds to the challenge posed by the recent revitalisation of the Primary Health Care approach and the report of the WHO Commission on the SDH, which call for studies to clarify the complexity and dynamics of the social processes involved in health development and their contribution to health equity and better health and nutrition.
Studies in rural areas of sub-Saharan Africa have shown that interventions to broaden participation and stakeholder participation can change the social determinants and lead to reduced child malnutrition but there is a gap in the evidence base for urban slum areas. This gap needs to be addressed because rapid rates of change and growth in many cities in developing countries have led to ineffective responses to the impacts of urbanization on child nutrition and to concern over high levels of child malnutrition. This research will therefore be conducted in the city of Mombasa in Kenya where child undernutrition in the slum areas is a serious public health problem. It will also be conducted in the major city of Valparaísoty in Chile which is of comparative interest because there are spiralling rates of child obesity is slum areas.
The study will use a cross-disciplinary approach drawing on the fields of health, food and nutrition, education, social development and governance to help 'join up' research, policy development and implementation across disciplinary boundaries.
","The study will be implemented in 3 phases.
The impact of these actions will be assessed quantitatively through collection of weight-for-height, weight-for-age and height-for-age data collected in baseline and follow-up surveys and any change in nutritional status will be measured using a controlled experimental design.
Qualitative data will also be collected to illuminate the process (actions, pathways and mechanisms -including those in existing structures) through which any change in nutritional status has been achieved.
","","Poor households living in slums of Nairobi, Mombasa and Kisumu","Poor households living in slums of Nairobi","","Weight-for-height, weight-for-age and height-for-age data collected in baseline surveys will be measured ","Weight-for-height, weight-for-age and height-for-age data collected at follow-up surveys and any change in nutritional status will be measured using a controlled experimental design. ","Vulnerable groups","","Conditional cash transfer programmes and nutritional status>>>Conditional cash transfer programmes and nutritional status>>http://www.who.int/elena/titles/cash_transfer","Financial resources","The cash transfer for poor households was put at Kshs 1,500 per month (within the urban food poverty line estimated at Kshs 1,490). Although it was considered an important learning process, government funding has not come through. The WFP and Oxfam/World are currently implementing the programme in limited informal settlements of Nairobi.","","","","","","","","","","","","","","","","","","","","Evidence is beginning to emerge of over-nutrition in slum areas. This is mainly due to the fact that not all slum residents are poor, uneducated and migrants from rural communities, even though they live in the same environments. Differences in income, migration status, education and ethnic background influence diet with those more able economically providing high sugar, high fat and high salt foods to their children.
","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Twice a year, at designated times, the three programs distribute capsules to children aged six months to five years. Each program follows a campaign model based upon intensified social mobilization and service delivery over two to seven days. The twice-yearly events have created a cadre of field-tested personnel in the three countries, who are skilled at working with the local communities and at promoting their support and active participation. All three programs have been associated with National Immunization Days (NIDs), a WHO global program to eradicate polio. Since NIDs were held annually, however, they provided an opportunity for only one dose of vitamin A each year. Because children with vitamin A deficiency should receive a supplement at least twice a year (every four to six months), another mechanism was needed for the second dose. Relying exclusively upon facility-based distribution to deliver the second dose was not a viable option for several reasons, but in particular because healthfacility attendance for older children was not high enough to ensure adequate coverage in the one-to-five-year age group.
In Zambia, the first non-NIDs vitamin A supplementation program was launched in August 1999, and later renamed Child Health Week (CHW) to make the focus on the child more explicit. It was also felt that, instead of limiting activities to a vertical vitamin A supplementation program, the opportunity should be seized to deliver an integrated service that included not only vitamin A capsules but also other health services such as de-worming, health education, immunization, family planning, prenatal care, and growth monitoring. Districts were encouraged to provide an integrated package of services commensurate with their local capacity and need — as long as vitamin A supplementation remained the core activity during that week. In Zambia, the first NIDs campaign took place in 1997, and was a nationwide undertaking. The program was scaled down to about half the districts in recent years. Since 1999, the focus has shifted to priority districts, where communities have been at a constant risk of cross-border polio infections due to civil-war-related migrations from neighboring countries. This narrower focus is referred to in Zambia as sub-NIDS.
The first round of vitamin A supplementation in Ghana was integrated into NIDs in 1996. By 1999, a detailed plan was developed to implement a nationwide stand-alone supplementation program for the second round. In 2000, the Ministry of Health (MOH) carried out the first vitamin A standalone capsule distribution in the country’s ten regions. Since that date, the program has become a two- to three-day stand-alone event used to deliver a second dose of vitamin A to all children 6 to 59 months of age. Volunteers from the Ghana Education Service, along with personnel from other decentralized departments, assist with the supervision and capsule-distribution effort. Community-based volunteers are in direct contact with caregivers and children and also work very closely with health workers, assemblymen, chiefs, opinion leaders, gong-gong beaters, and other community leaders to mobilize beneficiaries, administer vitamin A, and maintain distribution records.
In contrast to Zambia and Ghana, Nepal followed a phased approach to program implementation. Integration of vitamin A into NIDs in Nepal was initiated in 1997,
four years after a supplementation program was established in 8 of the country’s 75 districts. The second distribution campaign has since been phased in at a rate of eight to ten districts per year. By 2001, the program covered all but three politically unstable districts. Under the program, high-dose vitamin A capsules are distributed to all children aged 6 to 59 months during a twoday event.
","
Ghana
A monitoring team consisting of national, regional, and district supervisors carries out organized and random spot checks. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. Capsule-distribution teams use all means of transportation available within the region and district, whether these be 4x4 vehicles, 2x4 pickups, motorcycles, or bicycles. MOH, district assemblies, decentralized departments, and local and international NGOs provide fuel and contribute to vehicle maintenance. At the end of each day, tally sheets are counted and summary sheets completed. Data are compiled by sub-district and district health management teams. After all figures are checked for accuracy, district coverage is calculated. District coverage data are sent to the regional nutrition officers and senior medical officers of public health, who compile regional coverage figures before sending them to the Nutrition Unit in Accra. Using regional figures, the Nutrition Unit estimates national coverage.
Zambia
Monitoring teams consisting of national, provincial, and district staff carry out systematic or random observations, depending on what they are monitoring. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. At the end of each day, tally sheets are counted, summary sheets completed, and data compiled. District figures are then checked for accuracy, after which district coverage is calculated and the results forwarded to NFNC.
","Ghana: 3.5 million children ","Ghana: Exceeded target in May 2001; Zambia: 28 percent in 1999, 88 in Febraury 2002","","serum retinol levels of &lt;20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","serum retinol levels of <20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Insufficient staff","In Zambia and Ghana, it has been somewhat more difficult to generate a consistent cadre of volunteers for the vitamin A distribution. In each country, districts mobilize health post and sub-health post staff, identify extended outreach sites (including clinics, schools, and community centers),and then recruit community members to assist them with their activities. In Ghana, this has been relatively successful since there have been adequate clinic staff and a manageable number of outreach sites. In spite of this, many districts have continued to do some house-to-house visits to ensure high coverage. In Zambia, it has been more difficult to recruit community volunteers, and the clinic staff have been stretched to cover outreach sites.","","","","","","","","","","","","","","","","","","","","","Robin Houston (2003). Why They Work: An analysis of three successful public health interventions - Vitamin A supplementation programs in Ghana, Nepal, and Zambia
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Five data collection methods were used:
During the fieldwork, the enumerators worked in pairs. The enumerators were not allowed to use the instruments in the facilities where they worked. Each pair spent a full day at a health facility. Field supervisors supported the enumerators during the data collection and checked the questionnaires for consistency and completeness. This was to ensure that the data collected was accurate as possible.
","""""Many pregnant mothers do not come to ANC because they had several normal pregnancies and think all will continue to go on well always.”
- Health worker, Apac
“ The health worker at the health centre is very rude, she has no time for us; so we fear even asking questions or discussing any issue about our health. So I go all the way to Naguru health clinic and only here if I have no money for transport.”
- A pregnant woman, Kojja, Mukono
“ I think these tablets for blood should be given only to pregnant women who have no blood. It may cause a high blood level and lead to high blood pressure.”
- TBAs, Kyampisi
“ Women with increased blood should not take these tablets (iron and folic acids) because their heartbeats will increase and they will sweat very much.”
- TBAs, Seeta Nazigo
“ Some mothers say it smells and they throw away the tablets soon after the clinic.”
- Pregnant mothers, Kojja
“ Some mothers do not like taking tablets when they are pregnant.”
- Pregnant mothers, Seeta Nazigo
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Ethiopia
MOST is providing technical and implementation support to the Ministry of Health in the development of a national micronutrient program. The program is a cooperative effort between the MOH, USAID/Ethiopia, MOST, and UNICEF. Program components include strengthening of the newly formed nutrition division at the MOH and the micronutrient committee; development of a locally designed vitamin A supplementation strategy and its pilot test; support for initial trials of vitamin A sugar fortification in one of the country's four sugar factories; and support for information, education, and communication activities.
South Africa
MOST is working with counterparts at the University of the Western Cape (UWC) to support and strengthen a new vitamin A supplementation program being started by the Department of Health in Eastern Cape province. MOST is also supporting a pilot initiative by UWC that aims to incorporate micronutrient interventions into the Eastern Cape Integrated Nutrition Program.
.
","","","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","","","","","","","","","","","","","","","","","","","","","","","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Government agencies encouraged the initial development of fortification: NFNC promoted initial research, sponsored meetings, and coordinated activities related to fortification; MOH researched the legal framework; the National Institute for Scientific and Industrial Research (NISIR) provided technical guidance; the Food and Drug Control Laboratory (FDCL) conducted monitoring and evaluation; and the Zambian Revenue Authority (ZRA) examined the tax structure. Industry acceptance allowed planning to begin, but donor support was critical to the development of the program: the U.S. Agency for International Development (USAID) was the lead financer of the project and provided technical assistance, UNICEF provided spare parts, and the Japanese International Cooperation Agency (JICA) provided spectrophotometers for Zambia Sugar and the FDCL.
While legislation was still being developed, Zambia Sugar went ahead with the launch of fortified Whitespoon Sugar on May 15, 1998. Zambia Sugar began its fortification program at 15 mg/kg, but cost considerations led the company to reduce the level to 10 mg/kg within three months. In May 1997, one year before fortification began, a consultant estimated the cost of fortifying 100,000 metric tons of sugar at 16 mg/kg to be around $1 million U.S., while fortifying at 20 mg/kg would cost almost $1.25 million.24 Reducing the level from 16 to 10 mg/kg could thus have reduced costs by approximately $375,000 a year.
","Modified Relative Dose Response Test (MRDR) in children
","The first outside tests of fortificant levels in sugar were controversial. Four months after the launch of fortified sugar, a team consisting of representatives from the MOH, the NFNC, and NISIR visited the Zambia Sugar mill. The team tested samples from the mill at the FDCL; these tests showed far lower levels of vitamin A than those shown in tests by Zambia Sugar. The government’s tests indicated a range of 0–13.6 mg/kg, while Zambia Sugar’s tests indicated a range of 9–21 mg/kg for the same samples. Zambia Sugar believes that the samples suffered sedimentation in the transport to the government laboratory and that this explains the different results.
MOST, the USAID micronutrient program, sponsored the creation of training manuals for health inspectors and Food and Drug enforcement officers, as well as a national training workshop from September 24 to October 7, 2000. The workshop focused on inspection procedures and methods, provided laboratory training where appropriate, and included a trip to the Zambia Sugar plant. Since the implementation of that program, Zambia Sugar has expressed satisfaction with law enforcement efforts. UNICEF subsequently funded workshops at the district level, using reproductions of the training manuals that had been produced with MOST funding.
","nationwide","..","","","","Vulnerable groups","","","Financial resources","","Communication","","Financial resources","","Adherence","","","","","","","","","","","","","","","","","English" "11489","Nutritional Improvement for children in urban Chile and Kenya (NICK) Project","English","Multi-national","","KEN","Kenya","Mombasa, Kenya","Urban","on-going","01-2010","01-2013","NICK (Nutritional Improvement for children in urban Chile and Kenya) is a three year study that started in October 2010 with funding from the UK Government Department for International Development (DFID) through the Economic and Social Research Council. This study helps the cities of Mombasa in Kenya and Valparaíso in Chile reduce child malnutrition using participatory action research to broaden stakeholder participation at municipal level to change the social determinants. These determinants control the everyday conditions in which people are living and include education, income, working conditions, housing, neighbourhood and community conditions, and social inclusion. It is envisaged that this study will contribute to existing knowledge and also serve as a useful guide for action not only in Kenya and Chile but also in other countries with high levels of child malnutrition.
The NICK project is being implemented in one Mombasa informal settlement (with one matched control settlement). The project, which started on October 1st 2010 and ends on September 30th 2013, is guided by the following central question: Can child malnutrition amongst families living in poverty in informal settlements and slums in Mombasa and Valparaíso be reduced through broadening community and stakeholder participation to change the social determinants of nutritional status?
The project seeks to address the following research questions:
Given the recognition that the determinants of child malnutrition are systemic and require multi-disciplinary concerted efforts to address, the Kenyan research team decided to explore ways of ensuring that the project is integrated into the national efforts that focus on child nutrition. The initial steps, therefore, involved holding discussions with the Nutrition Division in the Ministry of Public Health and Sanitation (MOPHS). During these discussions (in January 2011), it emerged that there are multiple efforts being put in place to strengthen interventions on child malnutrition and related problems among the urban poor. One such initiative was the proposed formation of Urban Nutrition Working Groups (UNWG).
The Kenyan NICK team considered that establishing an UNWG in Mombasa was critical entry point that would help to make NICK activities an integral part of local initiatives with a high possibility of sustainability. This UNWG would function as the participatory action research (PAR) group that was needed for the NICK Project. The team, therefore, sought the support of the national nutrition office to do the following:
Following the granting of permission to work with the Provincial Nutrition Officer, several meetings were held in Mombasa to plan for an initial meeting with local stakeholders to introduce the project and form a Participatory Action Research (PAR) group. The agreement was that the UNWG would also serve as the PAR group. The research group also met with Dr. Shariff,3 the Director of Medical Services, in the Ministry of Public Health and sanitation (MOPHS) who was supportive of NICK and emphasized the need for the project to enhance the implementation of national nutrition priorities. The team also met with members of the Kenya Food Security Steering Group (KFSSG) who had just completed a national survey on Urban Food Security.
The preparatory phase was also utilized to carry out literature reviews and interviews to consolidate the situational analysis. A research permit was acquired, which was granted by the National Council for Science and Technology. With this permit, the Kenyan research team was able to plan for the baseline survey.
(i) Formation of the Provincial Nutrition Technical Committee and UNWG
This meeting was held in Mombasa on April 29th 2011. It brought together 24 participants who were drawn from the participating government departments and other partners. During this meeting, the team agreed to form the Provincial Nutrition Technical Committee under the leadership of the Provincial Nutritionist. Thirteen members were also nominated to form the UNWG under the leadership of the District Nutrition Officer. The members were supportive of this group due to the potential to have a coordinated approach to addressing child nutrition in the region.
(ii) Conduct of the baseline survey
During the initial meeting, it was agreed that the UNWG would be involved in carrying out the baseline survey. As part of community service, the members agreed that anthropometric measurements would be done for every child up to 5 years in the two study sites of Chaani (intervention) and Kongowea (control). Over 900 children were weighed and measured. Data from children 12-59 months indicate higher than national averages for stunting, with Chaani worse off than Kongowea.
The KDHS indicates high levels of stunting and underweight in the Coastal Province.
A household baseline survey was conducted (between June and July 2011) during which over 800 households were interviewed. The main issues addressed were child nutrition, health seeking behaviour and coping mechanisms. Data analysis is ongoing. The Kenyan team is now facilitating the UNGWA through three 6-monthly cycle of action and reflection to develop, implement and improve a range of small scale multisectiorial action to change the social determinants of child undernutrition.
(iii) 1st UNWG/PAR workshop – July 2011
This was a three-day meeting that was attended by 16 participants including the London-based researchers. A follow-up meeting for the UNWG was held on 20th July during which the first multisectorial action plan was finalised.
(iv) Community level activities
Community sensitization is ongoing. The UNWG has held meetings with health officials and village elders in Chaani (the intervention site). A public meeting was held with the community members on 7th November 2011, which was attended by over 250 people. So far 17 formalized groups have been identified and the next steps are to assess the training and research needs of these groups. Support for this group, in the form of training and provision of seed funds will be initiated in January 2011.
","
","","","Over 800 households; Over 900 children","","Anthropometric measurements","","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","Others, please specify below","Competing interestsThe UNWG members are very busy with multiple responsibilities, which limits the amount of time they have for NICK activities, which are seen as not being directly part of their mandates. The implementation of national level campaigns, such as the polio campaign, interfered with planned programme activities.","Others, please specify below","Time constraints among Government officialsIt was difficult for the research team to interview the district level officers as key respondents for the baseline survey due to time constraints. Although some of them are interested in research they are hard pressed to put aside an hour for an interview.","Management","Managing expectationsIt has been difficult due to the low project budget. In Kenya, there is a tendency for officers to be given allowances when they attend meetings. Doing this would deplete the project budget completely. The research team has shared the project budget with the UNWG and an agreement has been reached to facilitate travel but not to provide ‘sitting allowances’ as a compromise.","Adherence","Balancing between studies and field activitiesCombining the field activities and the research activities of the extension research project on domestic violence and child undernutrition led to some delay in the implementation of community level activities and the 2nd PAR workshop. These activities will be initiated in earnest in January 2012. The PAR workshop will be held in February 2012","","","","","","","","","","","","","","
The current project implementation process introduces a different mechanism of working in partnership at the community level for the implementation partners. Although the project has experienced some challenges, the achievement to-date indicates that with more support and additional training, the UNWG is in a position to implement sustainable interventions to address the social determinants of child nutrition. The baseline survey tools that will be used at the end of the project will be a good measure of whether this approach will have borne the anticipated outcome of multiple implementers working together for the common good.
","","English"