"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" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","STUDY DESIGNThe study consisted of an assessment using qualitative methodology. Within the focal area of FCT, four Area Councils were selected. First, the Area Councils were divided into urban/rural groups. Within each group, the “lucky dip” technique was used to pick two Area Councils. Within each selected Area Council, two urban and two rural communities were selected. Data collection was done at the health facility level. Health workers at the health facilities served as contact persons and mobilizers for respondents. In-depth interviews (IDIs) were conducted with key individuals in each of the communities, including traditional leaders, opinion leaders, community health workers, and community health volunteers. Focus group discussions (FGDs) were held amongst primary caregivers (mothers) of children under six months of age, primary caregivers of children between 6 and 24 months, grandmothers of under-24-month-olds, and fathers with children under 24 months of age.DATA COLLECTIONData collection instruments were developed for the target groups of the study. The instruments were pre-tested, on the basis of which some moderations were made. A methodology workshop was held to train the field officers and assistants a day before field work began. The training took place in the IYCN office in Asokoro, Abuja. During the training sessions, field assistants were taken through each instrument, and possible interpretations debated and agreed upon. Role-play sessions were also conducted. The workshop was facilitated by Dr Afolabi in conjunction with the principal investigator, Dr R. A. Okunola. Data were later collected at the different sites in FCT, coordinated by the principal consultant. Health officials of Area Councils to be visited were informed some days before the arrival of the study team, and necessary mobilizations were done. On arrival, courtesy calls were made to the traditional head and permission formally obtained for entrance into the community. Afterwards, the team proceeded to the health facility, where the various interviews and discussion sessions took place. Each FGD session was facilitated by a moderator and a note-taker while the sessions were tape-recorded. The collected data were transcribed and translated into English for the purpose of analysis.
","*
","","*","2 communities in 4 area councils of the Federal Capital Territory, Abuja","","","","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","","","","","","","","","","","","","","","","","","","","","","Working closely with the government is necessary to achieve sustainability beyond the life of the project. We have involved stakeholders from the government at all stages of planning and implementation of project activities. This has enabled government ownership of our activities, materials, and products, thereby ensuring their continued implementation after project closeout.Effective collaboration with key stakeholders is integral to success. We involved nutrition, PMTCT, and OVC partners from the beginning, ensuring they wereincluded in all stakeholder meetings and collaborating with them on program implementation.Integrating materials for health facilities and communities ensures consistent messages for caregivers. We found that developing the facility and community-based materials concurrently resulted in consistency of key messages for caregivers and helped establish a two-way referral system between facility-based health workers and community workers and volunteers.A cascade training approach can help programs with limited resources reach more health providers. We found that training master trainers at the national and state levels and engaging with a wide variety of partners to leverage resources helps to reach a wider group of health providers.
","“IYCN is the organization we recognize for nutrition in this country. Anything concerning nutrition we assign it to IYCN and listen to what they tell us and bring it back to stakeholders, review it and adopt it. Most of the time it involves a lot of technical discussion [with IYCN].”—Oby Okwuonu, Assistant Director, Orphans and Vulnerable Children Unit, Federal Ministry of Women’s Affairs and Social Development“This program is different because the focus is on the community. Health workers are trained to involve community counselors. This allows them tobe closer to the community.”—Aishatu Amiwe Zango, State Nutrition Officer and Trainer, Jigawa“Despite having a limited budget, IYCN has been able to reach a broad audience by integrating important infant feeding messages into government-owned documents that will reach many levels through cascade training.”—Dr. Bamidele Omotola, UNICEF
","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","STUDY DESIGNThe study consisted of an assessment using qualitative methodology. Within the focal area of FCT, four Area Councils were selected. First, the Area Councils were divided into urban/rural groups. Within each group, the “lucky dip” technique was used to pick two Area Councils. Within each selected Area Council, two urban and two rural communities were selected. Data collection was done at the health facility level. Health workers at the health facilities served as contact persons and mobilizers for respondents. In-depth interviews (IDIs) were conducted with key individuals in each of the communities, including traditional leaders, opinion leaders, community health workers, and community health volunteers. Focus group discussions (FGDs) were held amongst primary caregivers (mothers) of children under six months of age, primary caregivers of children between 6 and 24 months, grandmothers of under-24-month-olds, and fathers with children under 24 months of age.DATA COLLECTIONData collection instruments were developed for the target groups of the study. The instruments were pre-tested, on the basis of which some moderations were made. A methodology workshop was held to train the field officers and assistants a day before field work began. The training took place in the IYCN office in Asokoro, Abuja. During the training sessions, field assistants were taken through each instrument, and possible interpretations debated and agreed upon. Role-play sessions were also conducted. The workshop was facilitated by Dr Afolabi in conjunction with the principal investigator, Dr R. A. Okunola. Data were later collected at the different sites in FCT, coordinated by the principal consultant. Health officials of Area Councils to be visited were informed some days before the arrival of the study team, and necessary mobilizations were done. On arrival, courtesy calls were made to the traditional head and permission formally obtained for entrance into the community. Afterwards, the team proceeded to the health facility, where the various interviews and discussion sessions took place. Each FGD session was facilitated by a moderator and a note-taker while the sessions were tape-recorded. The collected data were transcribed and translated into English for the purpose of analysis.
","*
","","*","2 communities in 4 area councils of the Federal Capital Territory, Abuja","","","","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","","","","","","","","","","","","","","","","","","","","","","Working closely with the government is necessary to achieve sustainability beyond the life of the project. We have involved stakeholders from the government at all stages of planning and implementation of project activities. This has enabled government ownership of our activities, materials, and products, thereby ensuring their continued implementation after project closeout.Effective collaboration with key stakeholders is integral to success. We involved nutrition, PMTCT, and OVC partners from the beginning, ensuring they wereincluded in all stakeholder meetings and collaborating with them on program implementation.Integrating materials for health facilities and communities ensures consistent messages for caregivers. We found that developing the facility and community-based materials concurrently resulted in consistency of key messages for caregivers and helped establish a two-way referral system between facility-based health workers and community workers and volunteers.A cascade training approach can help programs with limited resources reach more health providers. We found that training master trainers at the national and state levels and engaging with a wide variety of partners to leverage resources helps to reach a wider group of health providers.
","“IYCN is the organization we recognize for nutrition in this country. Anything concerning nutrition we assign it to IYCN and listen to what they tell us and bring it back to stakeholders, review it and adopt it. Most of the time it involves a lot of technical discussion [with IYCN].”—Oby Okwuonu, Assistant Director, Orphans and Vulnerable Children Unit, Federal Ministry of Women’s Affairs and Social Development“This program is different because the focus is on the community. Health workers are trained to involve community counselors. This allows them tobe closer to the community.”—Aishatu Amiwe Zango, State Nutrition Officer and Trainer, Jigawa“Despite having a limited budget, IYCN has been able to reach a broad audience by integrating important infant feeding messages into government-owned documents that will reach many levels through cascade training.”—Dr. Bamidele Omotola, UNICEF
","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural|Peri-urban","completed","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","*
","","*","National coverage","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","","","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","","","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","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" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Deworming of children 0-2 years 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" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","","","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: For now we dont have national protocol but we conduct trainings on the management of SAM using WHO Guidelines.
","","","","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" "11454","Maternal, Infant and Young Child Nutrition Project","English","Multi-national","","MWI","Malawi","Salima District, Central Region, Malawi","Urban|Rural|Peri-urban","completed","01-2010","01-2011","From 2010 through 2011, the Infant & Young Child Nutrition (IYCN) Project supported Malawi’s Office of the President and Cabinet (OPC) to develop community-based nutrition services targeting mothers, infants, and young children, including HIV-positive populations. The project increased understanding of feeding behaviors, supported enhanced national policies, played a key role in shaping the country’s Scaling Up Nutrition (SUN) strategy, developed a package of training materials for a new cadre of community nutrition workers, and increased the capacity of community-based workers to improve infant and young child nutrition. We piloted capacity-building activities in Salima District, which will be scaled up nationally to improve the growth, nutritional status, health, and HIV-free survival of infants and young children.
","Examined caregivers’ feeding practices
IYCN conducted a joint research project with Bunda College of Agriculture and the World Bank to generate information that can be used to improve infant and young child nutrition activities within Malawi’s existing programs. The study was conducted in two phases: phase one was exploratory, and gathered information about feeding practices from 60 mothers with children 6 through 23 months of age and 18 key informants. In phase two, or the Trials of Improved Practices phase, counselors offered 100 mothers of children 0 through 23 months of age one to three improved feeding practices that they could try for about one week and gathered results from trying those practices.
","In a joint study with the World Bank, IYCN identified key infant feeding problems and tested practical solutions to inform new behavior change communication materials for community nutrition workers. Findings revealed that mothers could adopt new, improved practices, such as:
Formative research findings can help motivate stakeholders to take action.
The project’s formative research demonstrated that it is feasible for mothers in Malawi to make small changes in feeding practices that go a long way toward preventing malnutrition. These powerful findings influenced several national strategies and contributed to the country’s focus on prevention of stunting.
Training materials should meet the needs of community-based workers.
Because community-based workers selected for IYCN’s trainings lacked knowledge about the basic principles of nutrition, adapting the training materials to include this basic information, along with building counseling skills, led to the development of more effective tools for counseling caregivers. Mentoring and supportive supervision are a great way to reinforce concepts learned during a training session. We found that community workers were motivated to do the work when they received regular supervision and mentoring.
","“Indeed biscuits are expensive…and with the same amount of money, I can buy eight bananas.”
—Mother, Salima
Royce’s story: Small changes, big growth
When Gladys, a community health worker trained by IYCN, first met Linnes during a home visit, the young mother was concerned that her nine-month-old baby, Royce, had remained the same weight for the past three months. Sitting in the shade outside of Linnes’ mudbrick home in Nthiwatiwa village, Gladys asked her how she had been feeding her baby and used a set of illustrated counseling cards to suggest feeding changes. She advised that increasing the frequency of breastfeeding, making thicker porridge, and diversifying Royce’s meals could improve her growth and health. During several more home visits, Gladys found that Linnes was able to make these small feeding improvements; and after just two months, the baby’s growth improved significantly. Now, Linnes proudly shares her story with other mothers in the village.
","English" "11456","Infant and Young Child Nutrition Project","English","Multi-national","","LSO","Lesotho","Lesotho","Rural","completed","01-2007","01-2010","From 2007 to 2010, the US Agency for International Development’s Infant & Young Child Nutrition (IYCN) Project supported Lesotho’s Ministry of Health and Social Welfare (MOHSW) to improve the nutrition of mothers and their children younger than two years of age, with a focus on those affected by HIV. The project strengthened national nutrition and prevention of mother-to-child transmission of HIV (PMTCT) policies and programs and conducted supportive activities at health facilities and within communities. As a result of the project, there is now a strengthened referral system, which allows community health workers to refer mothers and children to providers at facilities and providers to refer their patients back to community health workers for followup. Building the capacity of a wide range of community workers resulted in supportive networks for improved feeding practices in many communities, including among village chiefs, traditional healers, and men’s groups.
","Enhanced national nutrition guidelines
IYCN helped to set a countrywide standard for improved feeding practices by supporting the revision of Lesotho’s National Infant and Young Child Feeding Policy and incorporating the World Health Organization’s guidelines on HIV and infant feeding into national PMTCT guidelines. In February 2010, IYCN assisted the MOHSW with presenting the infant and young child feeding guidelines to the Minister of Health.
Facilitated multisectoral collaboration
To effectively reach communities with information about optimal feeding practices, the project fostered collaboration among three government ministries to develop joint training and supervision activities. A cascade-style approach to training community workers enabled IYCN to reach more caregivers with nutrition support. For example, IYCN supported the MOHSW to train 29 trainers at the Ministry of Agriculture, who then conducted “step-down trainings” with 496 home economists and other workers. IYCN also trained trainers at the Ministry of Education, who then trained early childhood care and development teachers. Both sets of trainees gave health talks at local clinics. The home economists showed mothers how to prepare food for their children and the teachers led discussions about good nutrition. Additionally, IYCN collaborated with each ministry to train 246 traditional healers in villages and 30 mentor mothers from mothers2mothers about how to counsel HIV-positive mothers on infant feeding.
Increased community support
Over the life of the project, IYCN supported the training of nearly 750 community health workers to counsel mothers on infant and young child feeding. Trained community health workers increased community support for optimal infant feeding practices and improved social norms, individual attitudes, and infant feeding behaviors. Through household visits, community health workers reached pregnant women and breastfeeding mothers two to four times each month. Community health workers also helped health workers create breastfeeding Masoabicommittees in some villages, which included traditional healers, grandmothers, and priests. By sensitizing village chiefs, traditional healers, community councils, grandmothers, and men’s groups, community health workers broadened support for infant and young child nutrition, which led to more public discussions about the issue. The project informally integrated traditional healers into the referral system, through which they referred mothers to community health workers.
By performing supervisory visits with 270 health providers trained by the project, IYCN monitored the two-way referral system between facilities and community health workers. Project staff also monitored community activities initiated through the project, such as growth monitoring and promotion, health talks, the creation of keyhole gardens, and cooking demonstrations. Health workers reported significant improvement in community-based growth monitoring and promotion sessions and said they were better able to detect and refer children who were growth-faltering, while keyhole gardens became a user-friendly, inexpensive, local source of vegetables.
","Growth
","","","","","","","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","","","","","","","","","","","","","","","","","","","","","","Mamorena’s story: helping babies grow up healthy and strong
It wasn’t until Mamorena volunteered to be a community health worker in rural Lesotho that she learned why her first child was frequently ill as an infant. After she gave birth to her son, she only gave him water for the first seven days, delaying breastfeeding until his umbilical cord fell off—a common cultural practice in Lesotho. She eventually added breastmilk and soft porridge to his diet.
While in an IYCN training to be a community health worker, she learned that the addition of foods and liquids—even water—during the first six months of life puts infants at risk of illness, infection, stunted growth, and death.
After the training, when Momorena gave birth to her second son, she began breastfeeding immediately and exclusively. As a community health worker, she continues to share what she learned with people in her village.
Lesotho: Connecting communities with health care facilities to prevent malnutrition
At the Litsoeneng Health Centre, a small clinic in a remote area of Lesotho, Adelina, 40, a nurse, and Mabeata, 62, a community health worker in the nearby village of Khopolo, proudly tell the story of Tsepo. He’s a healthy 17-month-old boy who is learning how to walk and loves playing with other children. Mabeata and Adelina meet monthly to monitor his growth and make sure he stays healthy.
But this wasn’t always the case for Tsepo. When he was 8 months old, Mabeata visited his home to monitor his growth and discovered that he wasn’t gaining weight at a normal rate. Immediately, she encouraged his mother, Malehloa, only 16 years old, to take him to the clinic to correct the problem. After participating in a training workshop conducted by the Infant & Young Child Nutrition (IYCN) Project, the community health worker knew that it was critical to send babies with growth problems to the clinic as soon as possible. She even walked with Malehloa and Tsepo from Khopolo to visit the clinic.
“I was very concerned about Tsepo. I wanted to be there to help Malehloa understand the problem and coordinate with the nurses to follow up after the visit,” Mabeata explained.
At the clinic, Adelina—one of a small staff that includes three nurses and two counselors—asked the young mother questions about how she was feeding Tsepo. Malehloa, who stopped going to school once she was pregnant, had practiced exclusive breastfeeding since Tsepo was born. As a result, he had hardly been sick during his first six months and he was growing normally.
The problem with his growth probably started after that. Malehloa didn’t know that Tsepo needed complementary foods (other foods and fluids) in addition to breast milk to keep him well nourished now that he was older than 6 months.
To improve Tsepo’s nutrition, Adelina and Mabeata helped Malehloa identify foods she already had at home—like enriched porridge and fruits—that would be good for Tsepo. They encouraged her to continue to breastfeed in addition to feeding Tsepo enough nutritious complementary foods at the right frequency. To help him catch up on his growth as quickly as possible, Adelina gave Tsepo a nutritional supplement.
“I learned that breastfeeding alone does not satisfy the baby after six months, so I have to add other foods that are good for Tsepo,” said Malehloa.
Now, Mabeata makes frequent home visits to check Tsepo’s growth and ensure that Malehloa feeds him enriched porridge and other good foods several times a day. She smiles when she talks about how happy and healthy Tsepo is now. She has seen steady improvements in his growth.
“I am very proud. It gives me strength to see how Tsepo is growing,” she said.
Mabeata’s quick actions and persistent follow-up probably prevented Tsepo from becoming severely malnourished. In Lesotho, many babies, even those who have grown well for the first six months of life, do not receive adequate complementary foods—putting them at risk of malnutrition and making them more susceptible to severe childhood illnesses, stunted growth, developmental delays, and death. Volunteers like Mabeata are the critical link between communities and the life-saving prevention and treatment available at health facilities.
To prevent malnutrition, the IYCN Project is working to improve the links between health facilities and communities like Khopolo. IYCN provides infant and young child feeding training workshops for community health workers, emphasizing increased collaboration with health facilities. Since IYCN conducted a training workshop at the Litsoeneng Health Centre for Mabeata and 30 other community health workers—one for each village in the area—the clinic staff have seen an increase in referrals for growth-faltering from community health workers.
Adelina believes that community health workers are vital to improving the health of mothers and children served by the clinic. She says it’s not always easy to get families to the facility. They often prefer to go to traditional healers in their villages or they do not have time to walk—sometimes more than six miles to the clinic
“We cannot afford to go house to house. If we need to get information to the villages, the community health workers are there on our behalf,” Adelina said.
Mabeata has all of the qualities necessary to go door to door to teach mothers about good feeding practices. She is well respected, empathetic, and a responsible mother—that’s why everyone at a village council meeting pointed to her when the clinic needed a volunteer to promote good health in the village 19 years ago. Her advice goes a long way toward making sure children have a chance for a healthy life.
“Now I tell other moms about Tsepo’s story and how we helped him. I think it motivates them to improve feeding practices for their babies,” Mabeata said.
","English" "11470","Integrated Family Health Program (IFHP)","English","National","","ETH","Ethiopia","Addis Ababa, Ethiopia|Amhara, Ethiopia|Benishangul-Gumuz, Ethiopia|Oromia, Ethiopia|Southern Nations, Nationalities, and People's Region, Ethiopia|Tigray, Ethiopia","Rural|Peri-urban","on-going","01-2008","01-2013","The Integrated Family Health Program (IFHP) supports the Government of Ethiopia’s Health Extension Program (HEP) and reaches over 32 million people—40% of the Ethiopian population—in 300 districts. Through assistance to over 13,000 health extension workers (HEWs) and thousands of community volunteers, USAID supports the delivery of key maternal, neonatal and child health services at the community level. These services include:
Goal:
Improve family health, especially for mothers, newborns, and children.
Project Objectives:
IFHP emphasizes a continuum of care approach at household/family, community and health facility levels through the provision of selected evidence-based and high-impact packages of services. This project plays an integral role in assisting the Ministry of Health to develop and change national policies, such as the use of antibiotics at the community level. The project supports the Government of Ethiopia in its Health Sector Development Plan and enhancing the Government’s management capacity as decentralization continues, leaving behind a well-functioning health system. By increasing the quality of health workers at the primary health care level and increasing demand for quality services, IFHP improves health behaviors and utilization of services. Additionally, IFHP also strengthens the promotion of essential nutrition actions with a strong focus on behavior change at both the community and facility level.
","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","While Tanzania has achieved high vitamin A supplementation coverage over the past few years, there is concern that this achievement is fragile because of decentralization. A2Z is supporting national, zonal, regional, and district health teams to institutionalize twice-yearly distributions through ongoing advocacy and routine planning and budgeting. This activity is conducted in collaboration with the National Program for Extension of Tools and Strategies, the Tanzania Essential Health Interventions Project, Ifakara Health Research and Development Centre, the Tanzania Food and Nutrition Center (TFNC), and UNICEF. To foster sustainable vitamin A supplementation, the A2Z project is supporting behavior change communication through community workers and a popular radio serial. Based on information gathered on sustainability indicators by TFNC with support of A2Z and HKI, those districts that have not yet integrated funding for vitamin A supplementation in their plans are receiving additional technical support. Several resources developed in Tanzania are available to ensure program sustainability.
","Given the twice-yearly nature of the VAS program as well as its historic evolution from immunization campaigns, it is easy for district staff to see the program as separate from their regular day-to-day work. Considering the program to be part of the routine work for the district is critical for sustainability, and is reflected in both attitudes and the support provided to the program. Ninety-one (76%) of the 119 districts regarded implementation of the twice-yearly VAS and deworming program to be a routine activity. About 84% considered VAS and deworming a very important service, and 99% thought the service should continue. Although the majority of the districts viewed VAS/deworming as a routine activity, more than half (55%) had not yet included VAS/deworming services in their routine supervision checklist. Moreover, payment of allowances to staff for VAS/deworming while at their normal duty stations implies that these services were viewed as special rather than routine. The allowance scheme in particular, with an excessive number of supervisors at some distribution sites and inadequate supervision at other sites, may increase a district’s vulnerability to a decline in coverage. Overall, 11 districts (9%) were judged vulnerable with low sustainability related to supervision and monitoring
","Those districts that have not yet integrated funding for vitamin A supplementation ","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Others, please specify below","For an activity to be sustained, it must be considered part of the district’s regular activities, and thus must be included in the annual planning process.","Management","The VAS program requires clear management for effective and efficient implementation, and thoughtful management also reflects the value placed on the program. Poor management may make the program vulnerable, and less likely to be sustained in an effective fashion.","Supplies","The VAS program depends on effective logistics, and capsule and promotional materials must reach distribution sites on time and in adequate quantities for the program to be effective. Poor logistics supply management makes the program vulnerable. Adequate communication between programs and departments within district councils facilitated effective use of available resources in 117 (98%) of the districts assessed.","Financial resources","Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.","Insufficient staff","Twice yearly VAS distribution involves extended outreach to communities, and thus requires significant mobilization of both health staff and community volunteers. Failure to plan for adequate human resources is likely to place districts at risk of not sustaining their coverage achievements.","","","","","","","","","","","","Planning
Districts should be encouraged to budget for the program in their own CCHP budget including the basket fund which is considered the most reliable source of funds. Once basket funds are planned, they cannot be reallocated
Advocacy and community ownership
The program is more likely to continue effectively if it is understood and valued by community members who are involved with planning and implementation.
Management and Leadership
Efforts should be made to protect the current best practices in management and leadership reported in most of the districts.
Logistics Supply
Key actors at the national level need to ensure timely procurement and delivery of supplies to the districts
Supervision and Monitoring
Districts should determine the appropriate number of site supervisors to contain costs and include VAS/deworming in the routine supervision checklist to ensure that children missed during the twice-yearly events are reached through “mop up” actions.
Advocasy and Community Ownership
The successful efforts to date should continue to build community ownership of the program through well-designed, regular sensitization meetings and advocacy to engage the community, mobilize participation, and raise the profile of VAS/deworming events.
Availability of Financial Resources
Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.
Availability of Human Resources
Local councils and the central government need to fill staff positions and find secure mechanisms to ensure mobilization of adequate human resources to sustain service delivery.
Programme Effectiveness
Efforts should be made to maintain the high performance of the majority of districts and help the few low performing districts improve their coverage.
","","English" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","With advocacy from A2Z/HKI and other donors, the Government of Tanzania in December 2006 adopted a policy for the use of zinc for the treatment of diarrhea. A2Z/HKI provided technical support to the National IMCI coordinator to incorporate zinc therapy as part of diarrhea management and developed modified IMCI guidelines. Zinc treatment and low osmolarity solution oral rehydration salts (ORS) have been incorporated into the National Standard Therapeutic Guidelines. The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University. The formative research also tested the acceptability of zinc treatment for diarrhea among mothers and caretakers. The findings of the study are expected to be used to assist in the development of health worker training modules and behavior change communication materials for use by the Ministry of Health and Social Welfare and the community.
","Under-five mortality rate
","","","","","","","Vulnerable groups","","Zinc supplementation in the management of diarrhoea>>>Zinc supplementation in the management of diarrhoea>>http://www.who.int/elena/titles/zinc_diarrhoea","","","","","","","","","","","","","","","","","","","","","","The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University.
","","English" "11475","Empowering New Generations in Improved Nutrition and Economic Opportunities (ENGINE)","English","National","","ETH","Ethiopia","Amhara, Ethiopia|Oromia, Ethiopia|Southern Nations, Nationalities, and People's Region, Ethiopia|Tigray, Ethiopia","Urban|Rural|Peri-urban","on-going","01-2011","01-2017","ENGINE is a five year integrated nutrition program, which builds upon the GoE’s initiatives and renewed commitment to nutrition as well as the U.S. Government’s Global Health and Feed the Future Initiatives. ENGINE supports the implementation of the National Nutrition Program and will work to strengthen multi-sectoral coordination; build capacity at the policy and implementation levels and for pre-service education and training; support large-scale behavior change communication for nutrition; link nutrition, livelihoods and food security interventions; and integrate health and nutrition with private-public partnerships. ENGINE’s innovative interventions, including a robust learning agenda, will support and guide effective nutrition policy and practices to reduce undernutrition. Furthermore, the program will contribute to the Agriculture Growth Program as articulated in Ethiopia’s Comprehensive African Agriculture Development Plan (CAADP) by strengthening nutrition components.
In addition to the Feed the Future Initiative, funding from the Global Health Initiative includes support from the President’s Emergency Program for HIV/AIDS Relief (PEPFAR). ENGINE will operate in 100 woredas (zones) also targeted by the Agricultural Growth Program and supported by Feed the Future in the Amhara, Oromia, SNNP and Tigray regions, as well as at the national level.
","ENGINE’s core initiative is to prevent under nutrition by focusing on social behavior change, including linkages to livelihood and economic opportunities. The program strengthens linkages between agriculture, food security and nutrition by working in the same geographic zones as new Feed the Future agriculture and food security programs. In addition, it consolidates prior USAID investments in nutrition to ensure a coordinated response that meets the requirements of both the GHI and FtF.
ENGINE also works to expand USAID investments and technical leadership in providing nutrition support through a continuum of care, especially at the community level. By strengthening the quality and availability of nutrition services, as well as promoting nutrition education, the program aims to establish nutrition as an important issue within Government of Ethiopia ministries and throughout the country.
","The expected results for the program include:
“This is no ordinary nutrition program. We believe that nutrition is as much about food security as it is good health. Food security is not only about the quantity of food but also the quality of the diet and utilization of the food. We are joining efforts of our Feed the Future and Global Health Initiatives to achieve real food security that impacts the health and prosperity of Ethiopians.”
- U.S. Ambassador to Ethiopia Donald E. Booth
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Ghana, Feed the Future aims to help an estimated 860,000 vulnerable Ghanaian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 324,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Ghana is making core investments in three key areas:
1. To achieve food security, agriculture programs will focus on driving a step-change in the volume and value performance of core staple value chains—starting with rice, maize and soy—and improving the governance of marine fisheries resources.
2. To help reduce malnutrition and improve household resilience of vulnerable populations, agriculture and nutrition programs will focus on a) improving access to diverse quality food, b) improving nutrition-related behaviors within vulnerable households, c) developing community mechanisms to identify and address their food and nutrition problems, and d) strengthening coordination of government and other actors to meet food security and nutrition objectives.
3. To improve the nutritional status of women and children, nutrition programs will focus on:
In addition to these three core areas, environment, natural resource management, climate change, and gender are incorporated as cross-cutting issues in all programs and activities as guiding principles.
Target Regions
A strategic focus on the rice, maize and soy value chains for five years could raise tens of thousands of people out of poverty, 75 percent of whom would be in northern Ghana. Improving marine fisheries governance in the Western Region will benefit fishery households and increase the nutritional status of fish consumers across Ghana.
Highlights
Northern Zone. The rural northern regions have the highest rates of food insecurity in the country—as much as seven times the national average. The northern zone program will aim to improve economic opportunities and diversify household income by doing the following:
Coastal Marine Fisheries Zone. Poverty in the coastal areas of Ghana is extensive, with the average welfare level among food farmers in rural coastal areas 12 percent below that in large urban centers such as Accra. Marine capture fisheries are the major economic activity along the coast and their importance reaches far beyond the coast. There is strong evidence that Ghana’s coastal ecosystems are already seriously degraded and experiencing erosion and will undoubtedly be under growing pressure with an oil and gas industry on its way. The Feed the Future program will:
National Scale Nutritional Programming. In coordination with other development partners, Feed the Future will support the Government of Ghana’s implementation of a comprehensive program of community-based management of acute malnutrition through a comprehensive behavior change program. This comprehensive package will improve nutrition-related behaviors and will be incorporated into programming in the Western, Central, and Greater Accra regions. Operational research will be conducted in 2011–2012 to better understand the extremely high rates of anemia among children in Ghana. This research will be used to develop key nutritional aspects of Feed the Future programming and to shape a national child anemia strategy and program that can be undertaken by Ghana Health Service and its development partners.
","Ghana achieved significant reductions in poverty in the past from agricultural growth that came from area expansion, but today it must come from increased productivity and reduced pre- and post-harvest loss, which fuels increases in farm output and income. Thus, the Strategy is based on:
Sustainably Reduce Global Poverty and Hunger
Inclusive agriculture sector growth
Improved nutritional status especially of women and children
Improved Agricultural Productivity
Enhanced human and institutional capacity development for increased agricultural sector productivity
Enhanced Technology Development, Dissemination, Management and Innovation
Improved Agricultural Policy Environment (increase productivity)
Enhanced institutional capacity development for increased ag. sector productivity
Agricultural producer organizations strengthened
Expanding Markets and Trade
Enhanced Human and Institutional capacity dev’t for agribusiness growth
Property Rights to Land and Other Productive Assets Strengthened
Improved Post-harvest market information
Improved access to business development and sound and affordable financial and risk management services
Increased private sector investment in agriculture and nutrition related activities
Increased agriculture value-chain productivity leading to greater on and off-farm jobs
","
USAID/Ghana will continue using the basic methodology of its existing Performance Monitoring Plan (PMP) for 2009–2013 that includes its monitoring of regular Development Assistance funds, GFSR, and FTF funds. With technical support to be provided by USAID/Washington, USAID/Ghana will build on its current monitoring and evaluation (M&E) systems to design and establish a comprehensive new FTF M&E system and PMP in 2011. In addition, the Mission has several years of experience using the Initiative to End Hunger in Africa (IEHA) monitoring and reporting system which will form the foundation for FTF monitoring and reporting. Since Mission implementing partners will be the source of a great deal of information, their own monitoring and reporting systems will be set up to provide the appropriate sex-disaggregated data, results, indicators, followed by regular monthly, quarterly, semi-annual, and annual reports to comply with the Operating Unit’s overall M&E system requirements. The Mission will be more watchful in ensuring that sex-disaggregated data is collected at all levels of indicators (outputs, outcomes and impacts), and will use available resources to invest in more in-depth analysis of the impacts of programs on men and women.
Data Quality and Management: FTF M&E will benefit greatly from assistance provided by the USAID’s GSSP project to strengthen Ghana’s agricultural statistics system. A new system is being launched in 2011 called the Ghana Agricultural Production Survey (GAPS). The key improvements to be made in the current Multi-Round Crop and Livestock Survey (MRCLS) are a disaggregated and updated sample design (district representativeness), expanded scope and depth of (geo-referenced) agricultural information collected, and new and enhanced management system consisting of improved data management practices and tailored software for improved and timely data processing, monitoring, and reporting. This resource will provide unprecedented household (gender disaggregated) information on an annual basis to help report on a number of FTF indicators.
Other than the in-house sources of information, various other M&E analytical tools, structures, and approaches will be considered for establishing baselines and constant monitoring. These options include instruments like the Ghana Living Standards Survey (GLSS- the local version of the LSMS), Participatory Poverty and Vulnerability Assessment (PPVA), Poverty and Social Impact Analysis (PSIA), and the Northern Ghana Food Security and Nutrition Monitoring System.
Data from the Demographic and Health Survey, which was last conducted in Ghana 2008, provides the baseline for nutrition and maternal and child health interventions. The USG will support this survey again in 2011, and therefore will have access to important data to assess the impact of the program at its midpoint. The Multiple Indicator Cluster Survey, conducted by UNICEF with support from USAID and planned for 2011 and 2015, will provide impact data to assess the success of the FTF program in Ghana at the conclusion of this Strategy period.
Developing National/Regional Capacity to use Data: IFPRI (through the GSSP project) is helping to establish the CAADP Strategic Analysis and Knowledge Support System (SAKSS) Node and will continue to provide the professional guidance to the country to ensure high quality statistical data remains available.
In addition, a Technical Services staffer will support the ASWG Secretariat in carrying out its functions effectively, including tasks like helping stakeholders (especially MOFA) keep track of agricultural related public and private sector investments and foreign support to the sector. There may be times where additional design work will be needed to create results monitoring frameworks for new activities and assist in modifying existing frameworks by adjusting indicators, defining baselines and setting targets. In addition, the Mission will be a partner in Joint Sector Reviews of agricultural sector performance conducted jointly by MOFA and development partners according to a mutual agreement the Mission supports for transparency, accountability, benchmarking, and results monitoring.
Impact Evaluations: The USG will ensure that evaluations for FTF will be adequately covered by above mentioned Technical Services PASA. One of its primary objectives is to evaluate and assess impact of the USAID/Ghana/EG portfolio of investments, in relationship to GOG and donor portfolios, and in relationship to Ghanaian needs in order to make progress towards MDGs and sustaining status of a middle income country. This includes providing relevant information for design of new and/or scaled-up projects as USG increases its investments in Ghana.
Evaluations will include both qualitative and quantitative methods. The hypothesis is that the development process itself can have a significant impact on and bring change to the Ghanaian environment. The objective is to test how much influence FTF programs have had on human behavior, human attitudes (e.g., trust in value chain systems), business and commercial practices, establishment of value chain linkages, increased livelihood options, smoothed out income flow over time (not just level of income), institutional efficiency and quality service delivery, and the programs’ impact on reducing key gender disparities. In addition, the programs should be evaluated to see if they were effective enough to bring about a transformative change or improvement in the lives of the poor, mainly in the northern regions.
","A strategic focus on the rice, maize and soy value chains for five years could raise tens of thousands of people out of poverty, 75 percent of whom would be in northern Ghana","At least 40,000 food insecure households with women of reproductive age and children under two in the Northern region of Ghana","","Lead indicators will be: gross margins per hectare of rice, maize/soya; value of incremental rice, maize/soya sales; value of intra-regional trade in maize; and value of new private sector investments in these select value chains. Many of these will be disaggregated by sex (e.g., gross margins per hectare) of the farmer (not the household head).","Lead indicators will be: gross margins per hectare of rice, maize/soya; value of incremental rice, maize/soya sales; value of intra-regional trade in maize; and value of new private sector investments in these select value chains. Many of these will be disaggregated by sex (e.g., gross margins per hectare) of the farmer (not the household head).","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","","","","","","","","","","","","","","","","","","","","","","","","English" "11516","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","GHA","Ghana","Northern, Ghana|Western Region, Ghana","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Ghana, Feed the Future aims to help an estimated 860,000 vulnerable Ghanaian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 324,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Ghana is making core investments in three key areas:
1. To achieve food security, agriculture programs will focus on driving a step-change in the volume and value performance of core staple value chains—starting with rice, maize and soy—and improving the governance of marine fisheries resources.
2. To help reduce malnutrition and improve household resilience of vulnerable populations, agriculture and nutrition programs will focus on a) improving access to diverse quality food, b) improving nutrition-related behaviors within vulnerable households, c) developing community mechanisms to identify and address their food and nutrition problems, and d) strengthening coordination of government and other actors to meet food security and nutrition objectives.
3. To improve the nutritional status of women and children, nutrition programs will focus on:
In addition to these three core areas, environment, natural resource management, climate change, and gender are incorporated as cross-cutting issues in all programs and activities as guiding principles.
Target Regions
A strategic focus on the rice, maize and soy value chains for five years could raise tens of thousands of people out of poverty, 75 percent of whom would be in northern Ghana. Improving marine fisheries governance in the Western Region will benefit fishery households and increase the nutritional status of fish consumers across Ghana.
Highlights
Northern Zone. The rural northern regions have the highest rates of food insecurity in the country—as much as seven times the national average. The northern zone program will aim to improve economic opportunities and diversify household income by doing the following:
Coastal Marine Fisheries Zone. Poverty in the coastal areas of Ghana is extensive, with the average welfare level among food farmers in rural coastal areas 12 percent below that in large urban centers such as Accra. Marine capture fisheries are the major economic activity along the coast and their importance reaches far beyond the coast. There is strong evidence that Ghana’s coastal ecosystems are already seriously degraded and experiencing erosion and will undoubtedly be under growing pressure with an oil and gas industry on its way. The Feed the Future program will:
National Scale Nutritional Programming. In coordination with other development partners, Feed the Future will support the Government of Ghana’s implementation of a comprehensive program of community-based management of acute malnutrition through a comprehensive behavior change program. This comprehensive package will improve nutrition-related behaviors and will be incorporated into programming in the Western, Central, and Greater Accra regions. Operational research will be conducted in 2011–2012 to better understand the extremely high rates of anemia among children in Ghana. This research will be used to develop key nutritional aspects of Feed the Future programming and to shape a national child anemia strategy and program that can be undertaken by Ghana Health Service and its development partners.
","Activities will be implemented within the communities where staple crop value chain activities will take place, but will target vulnerable households that would not be captured by a staple crop value chain approach. Hopefully some of these households will eventually be able to participate in the larger commercial value chains as their condition improves. USAID’s efforts will concentrate on value chains in which women have some control and decision-making power over the production, processing, or marketing of the crops, or livestock, as well as control over the income derived from sales of those products. Examples of these include horticulture and small animal husbandry, which are generally managed and controlled by women. 16 In Ghana, activities of the USAID funded Global Livestock Project, ENAM (Enhancing Child Nutrition through Animal Source Food Management), showed positive results on improving production and consumption of animal source foods through a comprehensive approach that integrated income generation and nutrition education. USAID Title II programs in Ghana have also shown success in improving production of staple and non-staple foods. Nutrition and food safety education will be combined with microenterprise development so that men and women beneficiaries build resources and gain knowledge to provide safe and diverse diets to themselves, young children, and families. Male involvement is an essential aspect for the adoption of positive nutrition behaviors and practices.
Messages against child abuse and child trafficking as well as improved nutrition will be carried out among vulnerable households. Capacity-building in the use of good agricultural practices to prevent contamination of horticultural crops will result in higher yields and higher quality, safer products which will improve public health and develop markets for surplus products. Other aspects of household behaviors such as hygiene and sanitation are critical components to improve nutrition. Evidence shows that hand washing alone can reduce the incidence of diarrhea by 47 percent; diarrhea being both a potential cause and a consequence of undernutrition. By using evidence-based approaches (e.g., Community Led Total Sanitation), program activities will stimulate community mobilization and train local craftsmen (e.g., masons, carpenters) on inexpensive latrine construction or materials that could be purchased at the community level based on the types of latrines identified to construct by community members.
Improved access to diverse safe and quality food, especially for young children
Improved access to food can be accomplished through either direct consumption of produced goods or through purchase with improved incomes; most often improved access requires both approaches. In the northern areas of Ghana, both poverty and poor dietary diversity contribute to reduced access to diverse foods for the most vulnerable. Poverty is associated with lower consumption of a diverse diet including animal source proteins throughout Ghana, with particularly low diversity scores in the northern areas. Storage remains a major obstacle to food preservation and safety in Ghana that not only impedes direct access to food throughout the year, but also limits access to income since the majority of crops are sold post-harvest at low prices and then purchased at higher prices for consumption late in season. This strategy under the Agriculture Program explains that improving storage options will help address this problem.
The integrated program will require that implementing partners assess men’s and women’s roles to design interventions related to the four areas above that have the greatest chance for improving household and community resilience. For example, research on small-scale production activities through the ENAM Project found that men’s perception and appreciation of women’s activities had an impact on women’s empowerment and use of income for the household,17 underscoring the importance of including men in nutrition programs.
Improved nutrition–related behaviors within vulnerable households
Interpersonal communication, linked with community-based monitoring, will promote positive household behaviors related to nutritional health. This approach will encourage not only households but also communities to support broader measures such as hygiene and sanitation improvements, while helping reduce social and cultural barriers to improved nutrition-related behaviors, such as dietary restrictions based on age or gender. Positive practices that affect nutritional status of women and children will be promoted and supported through a combination of household visits, community outreach events, mother-to-mother support groups and other community groups. Men will be also targeted to promote their role in supporting positive nutrition-related behaviors.
This sub-program on nutrition behavior will be intertwined with and will build upon mass media and community behavior change activities undertaken through Program Objective Three. It will also be coordinated with other USG efforts such as the President’s Malaria Initiative (PMI), other USAID-funded health and agriculture programs, and related programs of the Ghana Health Service and other development partners and civil society groups to ensure complementarily and leverage additional resources and activities in target areas.
Communities able to identify and address their food and nutrition problems
Communities will establish food and nutrition objectives and will monitor their own progress by developing community-based nutrition monitoring systems. With data in hand, communities will be enabled to identify specific actions (e.g., diversified food production, fortification, improved storage or improved hygiene to reduce the incidence of diarrheal diseases) relevant to the local context and particular challenges. The integrated program will promote participatory practices that encourage men, women, and children to undertake and advocate for improvements to critical infrastructure through public works, facilitating effective engagement with local authorities, access to private sector credit, and potentially other support such as a small grants program. These actions will all be oriented to improve resiliency of households by allowing greater diversity and stability of income and access to food products.
One possible approach is to develop multi-sectoral collaborations to allow communities to systematically address food and nutrition challenges. All of the features of an improvement collaborative are applicable to improvement of services regardless of sector, including: shared improvement objectives; adequately supported quality improvement teams testing changes; an implementation package; regular analysis of measured results to guide quality improvement; shared learning for accelerated scale-up; spread of the successful strategy; and development or strengthening of relevant organizational structures.
Strengthened coordination of government and other actors to meet food security and nutrition objectives
USAID will work to strengthen cross-sectoral management of food security efforts at the central level as well as at the regional level. MOFA’s Women in Agricultural Development (WIAD) is working on several integrated initiatives targeting women farmers, focused on dietary diversity and increasing access to nutritious foods, and has also been involved in the CAADP and METASIP review processes.
On the health side, the interagency nutrition working group chaired by the Ghana Health Service will be strengthened as a planning and decision-making body for health-related nutrition efforts, and will be encouraged to work more directly with WIAD. Increasing support to WIAD and utilizing USAID’s position in health sector coordination to ensure that health actors become more involved with WIAD’s initiatives will greatly contribute to progress toward FTF objectives. These actions will provide a forum for sharing of best practices in cross-sectoral food security interventions, and will help WIAD to become the lead agency for coordinating interventions to improve food security for vulnerable households.
","
Increased resilience of vulnerable communities and households
Improved access to diverse and quality foods
USAID/Ghana will continue using the basic methodology of its existing Performance Monitoring Plan (PMP) for 2009–2013 that includes its monitoring of regular Development Assistance funds, GFSR, and FTF funds. With technical support to be provided by USAID/Washington, USAID/Ghana will build on its current monitoring and evaluation (M&E) systems to design and establish a comprehensive new FTF M&E system and PMP in 2011. In addition, the Mission has several years of experience using the Initiative to End Hunger in Africa (IEHA) monitoring and reporting system which will form the foundation for FTF monitoring and reporting. Since Mission implementing partners will be the source of a great deal of information, their own monitoring and reporting systems will be set up to provide the appropriate sex-disaggregated data, results, indicators, followed by regular monthly, quarterly, semi-annual, and annual reports to comply with the Operating Unit’s overall M&E system requirements. The Mission will be more watchful in ensuring that sex-disaggregated data is collected at all levels of indicators (outputs, outcomes and impacts), and will use available resources to invest in more in-depth analysis of the impacts of programs on men and women.
Data Quality and Management: FTF M&E will benefit greatly from assistance provided by the USAID’s GSSP project to strengthen Ghana’s agricultural statistics system. A new system is being launched in 2011 called the Ghana Agricultural Production Survey (GAPS). The key improvements to be made in the current Multi-Round Crop and Livestock Survey (MRCLS) are a disaggregated and updated sample design (district representativeness), expanded scope and depth of (geo-referenced) agricultural information collected, and new and enhanced management system consisting of improved data management practices and tailored software for improved and timely data processing, monitoring, and reporting. This resource will provide unprecedented household (gender disaggregated) information on an annual basis to help report on a number of FTF indicators.
Other than the in-house sources of information, various other M&E analytical tools, structures, and approaches will be considered for establishing baselines and constant monitoring. These options include instruments like the Ghana Living Standards Survey (GLSS- the local version of the LSMS), Participatory Poverty and Vulnerability Assessment (PPVA), Poverty and Social Impact Analysis (PSIA), and the Northern Ghana Food Security and Nutrition Monitoring System.
Data from the Demographic and Health Survey, which was last conducted in Ghana 2008, provides the baseline for nutrition and maternal and child health interventions. The USG will support this survey again in 2011, and therefore will have access to important data to assess the impact of the program at its midpoint. The Multiple Indicator Cluster Survey, conducted by UNICEF with support from USAID and planned for 2011 and 2015, will provide impact data to assess the success of the FTF program in Ghana at the conclusion of this Strategy period. Developing National/Regional Capacity to use Data: IFPRI (through the GSSP project) is helping to establish the CAADP Strategic Analysis and Knowledge Support System (SAKSS) Node and will continue to provide the professional guidance to the country to ensure high quality statistical data remains available.
In addition, a Technical Services staffer will support the ASWG Secretariat in carrying out its functions effectively, including tasks like helping stakeholders (especially MOFA) keep track of agricultural related public and private sector investments and foreign support to the sector. There may be times where additional design work will be needed to create results monitoring frameworks for new activities and assist in modifying existing frameworks by adjusting indicators, defining baselines and setting targets. In addition, the Mission will be a partner in Joint Sector Reviews of agricultural sector performance conducted jointly by MOFA and development partners according to a mutual agreement the Mission supports for transparency, accountability, benchmarking, and results monitoring.
Impact Evaluations: The USG will ensure that evaluations for FTF will be adequately covered by above mentioned Technical Services PASA. One of its primary objectives is to evaluate and assess impact of the USAID/Ghana/EG portfolio of investments, in relationship to GOG and donor portfolios, and in relationship to Ghanaian needs in order to make progress towards MDGs and sustaining status of a middle income country. This includes providing relevant information for design of new and/or scaled-up projects as USG increases its investments in Ghana.
Evaluations will include both qualitative and quantitative methods. The hypothesis is that the development process itself can have a significant impact on and bring change to the Ghanaian environment. The objective is to test how much influence FTF programs have had on human behavior, human attitudes (e.g., trust in value chain systems), business and commercial practices, establishment of value chain linkages, increased livelihood options, smoothed out income flow over time (not just level of income), institutional efficiency and quality service delivery, and the programs’ impact on reducing key gender disparities. In addition, the programs should be evaluated to see if they were effective enough to bring about a transformative change or improvement in the lives of the poor, mainly in the northern regions.
","This Resilience and Reduction of Undernutrition program will increase resiliency of at least 40,000 food insecure households with women of reproductive age and children under two in the Northern region of Ghana ","Northern region of Ghana","","Household Hunger Index; percent children stunted; households benefitting from USG assistance.","Household Hunger Index; percent children stunted; households benefitting from USG assistance.","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11516","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","GHA","Ghana","Northern, Ghana|Western Region, Ghana","Rural|Peri-urban","on-going","01-2011","01-2015","
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Ghana, Feed the Future aims to help an estimated 860,000 vulnerable Ghanaian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 324,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Ghana is making core investments in three key areas:
1. To achieve food security, agriculture programs will focus on driving a step-change in the volume and value performance of core staple value chains—starting with rice, maize and soy—and improving the governance of marine fisheries resources.
2. To help reduce malnutrition and improve household resilience of vulnerable populations, agriculture and nutrition programs will focus on a) improving access to diverse quality food, b) improving nutrition-related behaviors within vulnerable households, c) developing community mechanisms to identify and address their food and nutrition problems, and d) strengthening coordination of government and other actors to meet food security and nutrition objectives.
3. To improve the nutritional status of women and children, nutrition programs will focus on:
In addition to these three core areas, environment, natural resource management, climate change, and gender are incorporated as cross-cutting issues in all programs and activities as guiding principles.
Target Regions
A strategic focus on the rice, maize and soy value chains for five years could raise tens of thousands of people out of poverty, 75 percent of whom would be in northern Ghana. Improving marine fisheries governance in the Western Region will benefit fishery households and increase the nutritional status of fish consumers across Ghana.
Highlights
Northern Zone. The rural northern regions have the highest rates of food insecurity in the country—as much as seven times the national average. The northern zone program will aim to improve economic opportunities and diversify household income by doing the following:
Coastal Marine Fisheries Zone. Poverty in the coastal areas of Ghana is extensive, with the average welfare level among food farmers in rural coastal areas 12 percent below that in large urban centers such as Accra. Marine capture fisheries are the major economic activity along the coast and their importance reaches far beyond the coast. There is strong evidence that Ghana’s coastal ecosystems are already seriously degraded and experiencing erosion and will undoubtedly be under growing pressure with an oil and gas industry on its way. The Feed the Future program will:
National Scale Nutritional Programming. In coordination with other development partners, Feed the Future will support the Government of Ghana’s implementation of a comprehensive program of community-based management of acute malnutrition through a comprehensive behavior change program. This comprehensive package will improve nutrition-related behaviors and will be incorporated into programming in the Western, Central, and Greater Accra regions. Operational research will be conducted in 2011–2012 to better understand the extremely high rates of anemia among children in Ghana. This research will be used to develop key nutritional aspects of Feed the Future programming and to shape a national child anemia strategy and program that can be undertaken by Ghana Health Service and its development partners.
","Efforts to decrease poverty and improve options for food consumption will not have a significant impact upon the nutritional status of most Ghanaians unless they are accompanied by strong household and community understanding and motivation to change child feeding behaviors, and improvements in nutrition services and products that are offered to the public. For this reason, FTF in Ghana will invest resources through USAID/Ghana’s health program to prevent and treat undernutrition.
Improved nutrition-related behaviors and community norms regarding nutrition
USAID/Ghana is helping to expand and improve behavior change approaches related to nutrition and to develop training materials and approaches for infant and young children feeding and dietary diversity. In FY2011 a national Infant and Young Child Feeding (IYCF) campaign will be launched using mass media, a range of educational and community action materials, and community-led efforts and interpersonal communication by health staff and community volunteers. This campaign is expected to contribute significantly to improved feeding practices and increase the prevalence of minimum acceptable diet among children 6–23 months. USAID’s Behavior Change Support Program (BCS) will design the national campaign with the active involvement of the GHS, coordinating outreach activities with JICA (Japan International Cooperation Agency), UNICEF, and the World Bank, all of which are active in nutrition promotion in the northern regions. This will ensure that messages heard across the country are uniform and consistent. This national campaign will target all adults who care for children less than five years of age throughout the country. Heads of extended families and household decision makers (most often men) will be a particular target group for this campaign, to improve allocation of household resources towards child nutrition. USAID will support all outreach components of this intervention in the regions currently targeted by USAID’s overall health program (Greater Accra, Central, and Western), and in the northern regions targeted by the Feed the Future program, while the other areas of the country will receive the same package of outreach materials delivered through other actors (GHS with support from UNICEF, JICA, World Bank, etc.)
Key messages and related activities will promote the following behaviors: Exclusive breastfeeding through the first six months of life; Complementary feeding as of six months of age; Dietary diversity Maternal nutrition Care of sick children; Utilization of maternal, child health and nutrition services; Household water treatment Hand washing with soap Safe sanitation practices.
Expanded community-based treatment of acute malnutrition of children
Since 2008, USAID/Ghana has supported a community-based program to treat acute undernutrition (CMAM). Through the FANTA-2 project (Food and Nutrition Technical Assistance), USAID provides technical assistance to the Ghana Health Service (GHS) to integrate CMAM services into the district health system. A Severe Acute Malnutrition (SAM) Support Unit was established at the Nutrition Department of the GHS to provide technical support for CMAM implementation and coordination of CMAM activities in the country. From an initial pilot in two districts, the GHS plans to scale up the CMAM program nationally; USAID is already beginning this effort with support from UNICEF in the Northern Region. The CMAM platform also provides opportunities for improving the skills of health care providers, community outreach workers, mother support groups, and community health workers to provide quality nutrition services for mothers and children under two years of age.
To increase the reach and sustainability of the program to combat malnutrition in children, USAID is building private sector capacity for local production of ready-to-use food to be used in treatment of severely malnourished children. Local production is expected to start in FY 2011.
Expanded accessibility of safe quality foods available for child weaning in Ghana
The normal weaning foods used in Ghana are thin gruels based on cassava or other starches, which provide carbohydrates and assuage hunger but are otherwise quite poor in nutrition. In order to facilitate the adoption of improved weaning practices and increase the nutritional content of the diets of young children, USAID is exploring strategic partnerships to promote nutritional products that have a critical set of attributes including: a) would fill specific nutritional gaps in the existing diet of pregnant women and/or young children; b) can be marketed at a low enough price point to be feasibly accessible by the lower income segments of the population; c) has a reasonable chance of becoming sustainable over the medium term; and d) has significant existing support including investment from other private sector, government or civil society agencies.
A variety of actors, including private sector companies, Ghanaian universities, and non-governmental groups, have approached USAID with potential products and strategies in this regard. USAID will continue to track the progress of the different initiatives already underway, including several that already have support from other USAID programs such as CRSPs (Collaborative Research Support Program), and will determine whether any of them are likely to meet the four criteria listed above.
A critical related issue is access to clean and safe drinking water and sanitation facilities, which greatly impact the health of women and children and will be assessed and considered in the context of this intervention.
Causes of severe levels of anemia among children in Ghana identified and addressed
The levels of maternal and children anemia in Ghana, 59 percent and 78 percent respectively, actually increased between 2003 and 2008 according to the 2008 Ghana Demographic and Health Survey, even though other health indicators improved over the same period.
Maternal anemia is a major factor in both maternal and infant health in Ghana, which are the focus of USAID’s current maternal and child health program. To address the problem of maternal anemia, USAID/Ghana is providing support and technical assistance for quality prenatal services, coordinated with malaria prevention and deworming activities. USAID’s ongoing programs to improve the quality of maternal health services will include a sharper focus on maternal anemia prevention and treatment during the prenatal period.
Unlike maternal anemia, there is not a sufficient evidence base nor are there extensive programmatic experiences to inform child anemia programs. The causes of anemia in young children are multi-faceted, and while closely linked to maternal health and nutrition, cannot be explained by poor maternal nutrition alone. Many factors including dietary insufficiency during weaning, repeated bouts of malaria, diarrhea and other diseases, intestinal parasites, and even high prevalence of the sickling trait have been posited to explain the extraordinary levels of child anemia in Ghana. Some of these factors are being addressed through other programs, such as the expansion of malaria prevention programs and school-based deworming interventions. However there is a compelling need to obtain current information on the relative importance of contributing factors, service delivery challenges, and barriers to reducing prevalence of anemia in young children. USAID will consider supporting Ghanaian public health and nutrition research institutions to perform operations research that will include problem identification and the development and application of improved tools, technologies, and approaches for addressing child anemia. Approaches identified as being the most promising will be field tested by existing USAID health activities to determine their potential to be scaled up to a national level. This activity will be performed in collaboration with other established and recognized institutions to contribute to local capacity strengthening and sustainability.
","Improved nutrition related behaviors
Improved utilization of maternal and child health and nutrition services
USAID/Ghana will continue using the basic methodology of its existing Performance Monitoring Plan (PMP) for 2009–2013 that includes its monitoring of regular Development Assistance funds, GFSR, and FTF funds. With technical support to be provided by USAID/Washington, USAID/Ghana will build on its current monitoring and evaluation (M&E) systems to design and establish a comprehensive new FTF M&E system and PMP in 2011. In addition, the Mission has several years of experience using the Initiative to End Hunger in Africa (IEHA) monitoring and reporting system which will form the foundation for FTF monitoring and reporting. Since Mission implementing partners will be the source of a great deal of information, their own monitoring and reporting systems will be set up to provide the appropriate sex-disaggregated data, results, indicators, followed by regular monthly, quarterly, semi-annual, and annual reports to comply with the Operating Unit’s overall M&E system requirements. The Mission will be more watchful in ensuring that sex-disaggregated data is collected at all levels of indicators (outputs, outcomes and impacts), and will use available resources to invest in more in-depth analysis of the impacts of programs on men and women.
Data Quality and Management: FTF M&E will benefit greatly from assistance provided by the USAID’s GSSP project to strengthen Ghana’s agricultural statistics system. A new system is being launched in 2011 called the Ghana Agricultural Production Survey (GAPS). The key improvements to be made in the current Multi-Round Crop and Livestock Survey (MRCLS) are a disaggregated and updated sample design (district representativeness), expanded scope and depth of (geo-referenced) agricultural information collected, and new and enhanced management system consisting of improved data management practices and tailored software for improved and timely data processing, monitoring, and reporting. This resource will provide unprecedented household (gender disaggregated) information on an annual basis to help report on a number of FTF indicators.
Other than the in-house sources of information, various other M&E analytical tools, structures, and approaches will be considered for establishing baselines and constant monitoring. These options include instruments like the Ghana Living Standards Survey (GLSS- the local version of the LSMS), Participatory Poverty and Vulnerability Assessment (PPVA), Poverty and Social Impact Analysis (PSIA), and the Northern Ghana Food Security and Nutrition Monitoring System.
Data from the Demographic and Health Survey, which was last conducted in Ghana 2008, provides the baseline for nutrition and maternal and child health interventions. The USG will support this survey again in 2011, and therefore will have access to important data to assess the impact of the program at its midpoint. The Multiple Indicator Cluster Survey, conducted by UNICEF with support from USAID and planned for 2011 and 2015, will provide impact data to assess the success of the FTF program in Ghana at the conclusion of this Strategy period.
Developing National/Regional Capacity to use Data: IFPRI (through the GSSP project) is helping to establish the CAADP Strategic Analysis and Knowledge Support System (SAKSS) Node and will continue to provide the professional guidance to the country to ensure high quality statistical data remains available.
In addition, a Technical Services staffer will support the ASWG Secretariat in carrying out its functions effectively, including tasks like helping stakeholders (especially MOFA) keep track of agricultural related public and private sector investments and foreign support to the sector. There may be times where additional design work will be needed to create results monitoring frameworks for new activities and assist in modifying existing frameworks by adjusting indicators, defining baselines and setting targets. In addition, the Mission will be a partner in Joint Sector Reviews of agricultural sector performance conducted jointly by MOFA and development partners according to a mutual agreement the Mission supports for transparency, accountability, benchmarking, and results monitoring.
Impact Evaluations: The USG will ensure that evaluations for FTF will be adequately covered by above mentioned Technical Services PASA. One of its primary objectives is to evaluate and assess impact of the USAID/Ghana/EG portfolio of investments, in relationship to GOG and donor portfolios, and in relationship to Ghanaian needs in order to make progress towards MDGs and sustaining status of a middle income country. This includes providing relevant information for design of new and/or scaled-up projects as USG increases its investments in Ghana.
Evaluations will include both qualitative and quantitative methods. The hypothesis is that the development process itself can have a significant impact on and bring change to the Ghanaian environment. The objective is to test how much influence FTF programs have had on human behavior, human attitudes (e.g., trust in value chain systems), business and commercial practices, establishment of value chain linkages, increased livelihood options, smoothed out income flow over time (not just level of income), institutional efficiency and quality service delivery, and the programs’ impact on reducing key gender disparities. In addition, the programs should be evaluated to see if they were effective enough to bring about a transformative change or improvement in the lives of the poor, mainly in the northern regions.
","Reaching nearly 324,000 children, improving their nutrition to prevent stunting and child mortality.","About 75 percent of Ghanaians assisted would be in northern Ghana","","Lead indicators will include: prevalence of women with anemia; prevalence of childhood anemia; prevalence of diarrheal diseases, diet diversity among children under five; percent of children who are wasted.","Lead indicators will include: prevalence of women with anemia; prevalence of childhood anemia; prevalence of diarrheal diseases, diet diversity among children under five; percent of children who are wasted.","Vulnerable groups","","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" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","
The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of AIN-C is retrieved from the ENA Part II where AIN-C is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Monthly growth monitoring of children less than 24 months of age and sick children 24–60 months of age at the community centre, although home visits are provided for children who do not attend.
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C. participants to non-participants.
Mean height-for-age was lower in the AIN-C group as compared to non-participants at less than six months of age. At 6–11 months and 12–23 months of age, there was no difference between AIN-C children and nonparticipants, suggesting a protective effect of AIN-C against growth faltering. Since a pre-/post- comparison was not possible, this conclusion cannot be certain. Intensity of participation in the programme was based on percentage of possible weighings attended by the child; after controlling for household assets and age of child, for every 1% increase in participation intensity, weight-for-age increased 0.005 z-score.
","","Coverage of the programme by area was 24 of 42 health areas (>50%) in 2006 and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of AIN-C is retrieved from the ENA Part II where AIN-C is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Nutrition counselling for EBF less than 6 months of age
","Exclusive breastfeeding (EBF) rates
","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C participants to non-participants. Improved caring practices were reported among AIN-C mothers. A 15.8 ppt difference in EBF at 6 months was found (55.8% AIN-C, 40% non- AIN-C).
","","24 of 42 health areas (>50%) in 2006 (18), and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of AIN-C is retrieved from the ENA Part II where AIN-C is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Micronutrient distribution for children (iron and vitamin A)
","","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C participants to non-participants. With regard to receiving iron and vitamin A supplementation, differences of 36.1 ppt (65.6% AIN-C, 29.5% non-AIN-C) and 6.8 ppt (94.3% AIN-C, 87.5% non-AIN-C) respectively, were reported for children.
","","Coverage of the programme by area was 24 of 42 health areas (>50%) in 2006 and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of AIN-C is retrieved from the ENA Part II where AIN-C is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Nutrition counselling for complementary feeding less than 24 months of age
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C. participants to non-participants. Mean height-for-age was lower in the AIN-C group as compared to non-participants at less than six months of age. At 6–11 months and 12–23 months of age, there was no difference between AIN-C children and nonparticipants, suggesting a protective effect of AIN-C against growth faltering. Since a pre-/ post- comparison was not possible, this conclusion cannot be certain. Intensity of participation in the programme was based on percentage of possible weighings attended by the child; after controlling for household assets and age of child, for every 1% increase in participation intensity, weight-for-age increased 0.005 z-score
","","Coverage of the programme by area was 24 of 42 health areas (>50%) in 2006 and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English"