"programme_id","programme_title","programme_language","programme_type","other_program","iso3code","country_name","program_location","area","status","start_date","end_date","brief_description","references","related_policy","new_policy","partner_gov","partner_government_details","partner_un","partner_un_details","partner_ngo","partner_ngo_details","partner_donors","partner_donors_details","partner_intergov","partner_intgov_details","partner_national_ngo","partner_nat_ngo_details","partner_research","partner_research_details","partner_private","partner_private_details","partner_other","partner_other_details","cost","fsector_0","fpartner_0","fdetails_0","fsector_1","fpartner_1","fdetails_1","fsector_2","fpartner_2","fdetails_2","fsector_3","fpartner_3","fdetails_3","fsector_4","fpartner_4","fdetails_4","fsector_5","fpartner_5","fdetails_5","fsector_6","fpartner_6","fdetails_6","fsector_7","fpartner_7","fdetails_7","fsector_8","fpartner_8","fdetails_8","fsector_9","fpartner_9","fdetails_9","fsector_10","fpartner_10","fdetails_10","fsector_11","fpartner_11","fdetails_11","fsector_12","fpartner_12","fdetails_12","fsector_13","fpartner_13","fdetails_13","fsector_14","fpartner_14","fdetails_14","fsector_15","fpartner_15","fdetails_15","fsector_16","fpartner_16","fdetails_16","fsector_17","fpartner_17","fdetails_17","fsector_18","fpartner_18","fdetails_18","fsector_19","fpartner_19","fdetails_19","fsector_20","fpartner_20","fdetails_20","fsector_21","fpartner_21","fdetails_21","fsector_22","fpartner_22","fdetails_22","fsector_23","fpartner_23","fdetails_23","fsector_24","fpartner_24","fdetails_24","fsector_25","fpartner_25","fdetails_25","fsector_26","fpartner_26","fdetails_26","fsector_27","fpartner_27","fdetails_27","fsector_28","fpartner_28","fdetails_28","fsector_29","fpartner_29","fdetails_29","fsector_30","fpartner_30","fdetails_30","fsector_31","fpartner_31","fdetails_31","fsector_32","fpartner_32","fdetails_32","fsector_33","fpartner_33","fdetails_33","fsector_34","fpartner_34","fdetails_34","fsector_35","fpartner_35","fdetails_35","fsector_36","fpartner_36","fdetails_36","fsector_37","fpartner_37","fdetails_37","fsector_38","fpartner_38","fdetails_38","fsector_39","fpartner_39","fdetails_39","fsector_40","fpartner_40","fdetails_40","fsector_41","fpartner_41","fdetails_41","fsector_42","fpartner_42","fdetails_42","fsector_43","fpartner_43","fdetails_43","fsector_44","fpartner_44","fdetails_44","fsector_45","fpartner_45","fdetails_45","fsector_46","fpartner_46","fdetails_46","fsector_47","fpartner_47","fdetails_47","fsector_48","fpartner_48","fdetails_48","fsector_49","fpartner_49","fdetails_49","action_id","theme","topic","new_topic","micronutrient","micronutrient_compound","target_group","age_group","place","delivery","other_delivery","dose_frequency","impact_indicators","me_system","target_pop","coverage_percent","coverage_type","baseline","post_intervention","social_det","social_other","elena_link","problem_0","solution_0","problem_1","solution_1","problem_2","solution_2","problem_3","solution_3","problem_4","solution_4","problem_5","solution_5","problem_6","solution_6","problem_7","solution_7","problem_8","solution_8","problem_9","solution_9","other_problems","other_lessons","personal_story","language" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","
From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010The FMOH has developed a four-pronged national strategy for PMTCT: primary prevention of HIV infection; prevention of unintended pregnancies among HIV-positive women; prevention of HIV transmission from infected women to their infants; and treatment, care, and support of HIVpositive women and their infants and families. All health centers have a system of identifying infants born to HIV-positive mothers as part of their PMTCT program. 11The following is a brief description of the flow of PMTCT services, commencing from a woman’s first visit for ANC:All women coming for ANC are routinely informed—individually or in a group—about the benefits of HIV testing for mothers and babies. During this process—known as providerinitiated HIV counseling and testing—mothers reserve the right to say “NO.” Those who say “YES” will be tested.Women with positive results are referred to MSG mentors, and ANC follow-up continues. Their partners will also be tested.MSG mentors counsel an HIV-positive woman and transfer her to the ART nurse for antiretroviral drugs.The ART nurse takes a CD4 count. If not eligible for treatment based on her count, the woman will commence treatment and ANC follow-up continues. If she is eligible for treatment based on her count, she will be put on complete antiretroviral prophylaxis that starts at 27 weeks of gestation.Follow-up continues and the mother is advised to deliver at a health facility.At delivery, the infant will be started on prophylaxis as an HIV-exposed infant.A dried blood sample will be taken from the infant for polymerase chain reaction (PCR) testing after 45 days.Follow-up continues until cessation of breastfeeding, with re-screening done six weeks later.
","CD4 countsPCR test for HIV status of iinfant
","","x","Highly HIV prevalent regions","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","","Aberash, a 33-year-old woman, was in the 36th week of her pregnancy at the time of this assessment. She was not married and had tested HIV positive. Since the time she had learned her HIV status, Aberash had been visiting the health center in Shashemene at least once every week—and sometimes more often. Her primary concern was transmitting HIV to her unborn baby. Sr Terunesh*, the nurse responsible for ANC services at the health center, had been counseling Aberash on a number of issues related to her well-being and that of the baby. These discussions usually included nutrition-related issues, specifically breastfeeding and its potential hazards. In addition to these counseling sessions, Sr Terunesh had connected Aberash with the MSG for continued support, counseling, and encouragement, both from the mentors and from other mothers in the group.* Not her real name.
","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010Trials for Improved Practices (TIPs) is a relatively new and innovative methodology for Ethiopia, especially its use in shaping critical strategies to improve IYCF behaviors. The standard approach to TIPs implementation involves three household visits. The purpose of the first visit is to learn about current household feeding practices. The second visit is a ―counseling visit,‖ which includes the negotiating of a new practice with the mother or caregiver for her to try. The third visit is a follow-up visit to check on the mother’s experience in implementing the recommended/negotiated new practice. This ―negotiation TIPs‖ is mainly used in maternal and infant feeding, and identifies the best choices among a number of different actions that could yield IYCF nutrition benefits.
","Urban garden household participationFoods most frequently consumedHouseholds consuming at least four different food groups on a daily basis
","","x","Two similar, poor, urban populations from two districts (Adama and Debra Zeit)","","","","Socio-economic status","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","The results point to some specific areas that appear to be the most promising for improving complementary child feeding practices across the different age groups from 6 to 24 months:Improving the porridge/special food given to the child by adding different foods to enhance the quality and increase the energy density;Adding different mixtures to the porridge or giving different food combinations such as egg and potato;Adding fruits to the child’s diet, bearing in mind economic constraints that limit availability of fruit on a daily basis;Trying to introduce vegetables earlier, starting after six months and continuing (when mothers tried adding vegetables they found that their fears of ―doing harm‖ to the child were not justified); Increasing the amount of food provided in part by adding additional foods (fruits and vegetables); andUsing a separate bowl/plate for the child to facilitate monitoring the amount of food the child consumes.
","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Promotion of handwashing or hygiene interventions was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Promoting and implementation of delayed cord clamping was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing>>>Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing>>http://www.who.int/elena/titles/cord_clamping","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: Emergency Nutrition Intervention Guideline, August 2004
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: Protocol for The Management of Severe Acute Malnutrition, FMOH, March 2009
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010SamplingStudy participants were drawn from 45 communities in the nine project districts. The communities were selected based on the presence of mother support groups and church-based groups. In each district, purposeful sampling was used to select the female caregivers.1 The criterion used for selecting female respondents was that they were caregivers of children 6-24 months. Fathers2 of children 6-24 months, health workers, and community group leaders were selected using convenience sampling. Data collection methodsBoth qualitative and quantitative methods were used to conduct this study. Data were collected using a structured survey, in-depth interviews, and focus group discussions (FGDs) (see Appendix 2 for the study tools). Findings from all three sources were triangulated for the purpose of validation.Structured surveyEach study community was divided into six sub-areas, and one caregiver was selected from each sampled household within each sub-area, for a total of six participants per community.3Households in the cluster were numbered, and one was randomly selected. In a sampled household where there was more than one caregiver for the child aged 6-24 months, data collectors purposefully sampled for the interview one mother or caregiver who regularly fed the index child. In a situation where the selected caregiver had more than one child aged 6-24 months, the older one was selected as the index child. In-depth interviewsBased on the classification of health facilities in Brong Ahafo Region, we identified and selected four categories to use in the data collection exercise: district hospitals, clinics, health centers, and Community-Based Health Planning and Services compounds. In each district, five health workers were interviewed, including two health workers from the district hospital responsible for child welfare clinics (growth monitoring sessions) and one from each of the other three facility categories. Leaders of mother support groups and church-based groups at the community level whose activities could impact infant and young child feeding practices were also interviewed. In each district, five of these groups were randomly selected from a list of such groups within the district. Identification and sampling of the groups was done with the help of district-level health staff.
","From October 2010 to December 2011, the project:•Aired 855 radio spots with key messages on complementary feeding on Radio BAR, Omega FM, Success FM, Jerryson FM, Chris FM, Adarz FM, Star FM, and Royals FM. An additional 340 spots are scheduled to air in January 2012.Distributed 5,860 posters with key messages.Distributed 19,428 flyers with key messages.Trained 196 health workers and 137 community group leaders in appropriate complementary feeding practices and the use of BCC materials. Reached around 2,500 community group members with appropriate complementary feeding messages through trained group leaders.
","","45 communities in 9 selected districts in Brong- Ahafo region","45 communities in 9 selected districts in Brong- Ahafo region (","","Initiation of complementary feeding; Frequency of feeding; Feeding a variety of foods to children 6-24 months; Knowledge of three food groups; Caregivers who followed the World Health Organization’s (WHO) recommended practice of starting complementary foods at 6 months; Caregivers who gave fortified complementary foods to their children aged 6 to 9 months two or more times per day; Caregivers who gave their children aged 6 to 9 months porridge thick enough to stay on a spoon.","","Socio-economic status","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","Engaging District Health Management Teams is integral to success. IYCN and partners engaged district heads early in the process. As a result, they demonstrated strong support for the activities and they are poised to monitor the community-level activities to ensure effective rollout, dissemination, and distribution of BCC materials.Partnerships can help to expand reach. By collaborating with the BCS Project and leveraging a national behavior change communication campaign, the project was able to expand reach of the complementary feeding messages. Although the social marketing strategy targets the Brong Ahafo region, radio spots and BCC materials will be spread across the country as part of the Healthy Eating for Good Life campaign. Local partners at the district level, such as World Vision Ghana, also carried messages into districts outside of the project’s target area.Job-aids are necessary in communicating behavior change messages. Health workers in the target districts welcomed posters and leaflets that contained key messages and were grateful for them. It certainly made work easier for them. Since the orientations, community workers have displayed posters on walls in vantage points in all the communities and caregivers discussed the contents of the leaflets at community meetings.
","In addition to breastmilk, we give local dishes like palm nut soup with soya beans, banku and groundnut soup, fufu with soup, kontomire [cocoyam leaf] with soya beans, and fish soup. We also give them oranges and pineapple — FGD with women Sunyani West District.At weighing, we are taught how to dress the child, breastfeeding, cleanliness, sleeping under mosquito nets, and family planning, how to feed the child. — FGDs with women Jaman South and Sunyani West Districts“I learned a lot of things here. You see my son likes the breastmilk and the only other thing he will eat is porridge; so I am going to read this leaflet so that it will guide me on what to feed him. You see he is my firstborn so his health is important to me.” —Nursing mother“This project is a good start of what we want to see in the community; that the caregiver is empowered to be in charge of the health and good development of their children. What I would also like to see is strengthening the skills and competencies of the health providers so that [they] would be able to help caregivers do appropriate feeding especially for the children under two years.” —Mrs. Wilhelmina Okwabi, Deputy Director of Health Services (Nutrition)“I was part of the data collection process and listening to the preliminary results gives me a sense of ownership; also the results show what is happening in the district and it shows us the work we are doing in the districts. We’ve learnt a lot here. We are going back to educate the mothers on what they are not doing well and encourage them to continue the good feeding practices.” —Technical officer, Vivian Dapaah District“We are thinking of ending malnutrition in children in line with Millennium Development Goal 4. If we don’t feed them well we cannot achieve this. That is why this [IYCN] project is very important and timely for the Regional Health Directorate.” —WS Supiimeh, Regional Health Promoter
","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","","","","","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","","","","","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","","","","","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9144","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","GHA","Ghana","Ghana","Urban|Rural","completed","01-2010","01-2011","In 2010 and 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project provided technical assistance to the Global Alliance for Improved Nutrition (GAIN) to promote appropriate complementary feeding practices and encourage increased use of high-quality, fortified complementary foods to curb malnutrition among children 6-23 months of age.
Working in nine districts of Ghana’s Brong Ahafo Region, the project used a social marketing approach to engage households and communities through radio spots, radio discussions with community health workers and community leaders, and use of social and behavior change communication materials. These behavior change techniques aimed to increase knowledge and application of appropriate complementary feeding practices among low-income households caring for young children.
","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","Urban|Rural","completed","01-2006","01-2011","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010Study preparation and data collectionDue to the post-election violence that occurred in Kenya in January and February 2008, initiation of this study was postponed from its original start date of January 2008 to May 2008 to ensure the safety of the field team. The study team for Western Province included one field supervisor and four research assistants who were fluent in the local Luhya and Swahili languages. The study team for Eastern Province included one field supervisor and four research assistants who were fluent in Kamba, Swahili, and Kikuyu. A data analyst was also hired to enter and clean data in real time, as well as to assist with data analysis. Study procedural training was held with the entire study team, led by Dr. Kiersten Israel-Ballard and Ms. Margaret Waithaka, May 19–23, 2008. This included pretesting the data collection tools, revising all translations as needed, and piloting them in multiple languages at a local clinic. The study launch was on May 26 for Eastern Province, with field support from Dr. Israel-Ballard, and June 2 for Western Province, with field support from Ms. Waithaka. The data collection tools utilized in this study are available upon request.Study populations and proceduresThis cross-sectional study was designed to collect formative research data in a descriptive manner. This study took place at APHIA II (AIDS, Population and Health Integrated Assistance [USAID-funded program]) affiliated sites in the Kakamega, Vihiga, Hamisi, and Bungoma Districts of Western Province and in the Kitui, Makueni, Kibwezi, Machakos, Mwala, Yatta, Mwingi, and Mbooni Districts of Eastern Province. These regions were selected to include food-secure areas of Western Province and food-insecure areas of Eastern Province. Data collection occurred between May and September 2008. According to the 2007 Kenya AIDS Indicator Survey, Eastern Province had an HIV prevalence of 4.7 and Western Province of 5.1.This study was composed of a convenience sample of quantitative in-depth interviews, brief post-counseling exit interviews, and counseling session observations. A total of 386 women older than 18 years of age were recruited. In-depth interviews were conducted with 285 women (137 in Eastern Province, 148 in Western Province). Women known to be HIV positive were recruited from PMTCT clinics, comprehensive care centers, and postnatal wards at local clinics and referral hospitals, as well as from support groups affiliated with the health centers. Inclusion criteria included being HIV infected, having an infant <18 months of age, and having stopped breastfeeding between 1 week to 6 months prior to participation. Survey questions focused on the period over which breastfeeding cessation took place, including the age of the infant, liquids and foods fed during this period and their associated costs and availability, infant illness, breast health, general challenges, as well as a 24-hour dietary recall to capture current infant feeding practices and challenges. Infant weight and mid-upper arm circumference (MUAC) were measured to capture current nutritional status.Post-counseling exit interviews were conducted with 80 women (50 in Eastern Province, 30 in Western Province) who had not participated in the cross-sectional survey. The difference in sample size between provinces was due to clinic staffing shortages, resulting in the lack Kenya Infant Feeding Assessment 5 of individual postnatal counseling in Western Province; group PMTCT counseling was more commonly practised Women known to be HIV positive were recruited upon leaving an antenatal or postnatal PMTCT counseling session at a health facility. Inclusion criteria included being HIV positive, being pregnant, or having an infant <12 months of age. Counseling session observations occurred 22 times with different women and in various clinics (9 in Eastern Province, 13 in Western Province). Inclusion criteria included being HIV positive, being pregnant, or having an infant <12 months of age. In Eastern Province, four of these observations were antenatal and five were postnatal; in Western Province nine were antenatal and four were postnatal. Antenatal mothers were recruited in the antenatal care (ANC) clinic in the PMTCT section. Postnatal mothers were recruited in the comprehensive care center or in the maternal and child health (MCH) ward. Three observations were of ANC group counseling sessions rather than individual sessions; two in Western, one in Eastern. The observer used a check list to indicate whether a specified topic had been covered during the session. Although recruitment criteria were inclusive of both antenatal and postnatal mothers with infants under 12 months of age, most (n = 8) of the mothers interviewed postnatally had infants of only 1 month of age, while one mother had a 3-month-old and another had a 9-month-old infant, thus limiting the infant age ranges. All clients who met the recruitment criteria and consented to join the study during the recruitment period were recruited. To ensure eligibility and guardianship of the infant we required identification documents prior to enrollment. Additionally, 11 local stakeholders, including district and provincial nutritionists and nursing officers from Nairobi and Eastern and Western Provinces, were informally interviewed to gather their perceptions and attitudes toward infant feeding in the context of HIV in their communities.
","Weightfor-age (WFA) z-score,Upper-arm-circumference-for-age z-scoreMUACcount of the number of morbidities (0 to 5) the infant experienced during or subsequent to weaning, chosen from a list of five morbidities (respiratory symptoms, diarrhea, dehydration symptoms, fever, and refusal to eat)
","To monitor the progress of infant feeding and HIV activities, IYCN provided reporting tools which included a form to help APHIA II Western-supported PMTCT counselors accurately report on their facility-based activities in a standardized way, and to provide an opportunity to share successes and challenges; an observation checklist to provide structured feedback to facility-based counselors to improve their counseling and facilitation skills; and a reporting form for community-based workers to report on infant feeding activities. Subsequently, several PMTCT and HIV partners adopted the tools for use in their programs.
","*","Western and Eastern Province","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Confirming our post-counseling exit interview findings, we observed that few counselors discussed safe water as part of their AFASS assessment. Yet, this is a crucial factor for decision-making in this study population given that the most common water sources cited among mothers interviewed were rivers, dams, or open ponds. We also noted that the costs of replacement feeding were rarely mentioned. Interestingly, we observed more emphasis placed on risks from replacement feeding than on those from breastfeeding during ANC, but the opposite emphasis during postnatal visits, perhaps due to the perceived fear of infecting an otherwise healthy-looking infant. Regardless of when the counseling takes place, an accurate representation of risks and benefits associated with all infant feeding options needs to be conveyed to mothers. It was reassuring to note that most counseling sessions included discussion around how to stop breastfeeding, including mentioning that cessation should not occur until 6 months and that AFASS criteria should be in place, and providing an explanation of how a mother should physically stop breastfeeding (i.e., reduce number of breastfeeds per day) and how long the transition should take. However, as with the exit interviews, few mentioned manual expression to prevent breast pathologies. Although complementary foods were often discussed, mothers needed more detailed information on Kenya Infant Feeding Assessment 28 timing, frequency, quantity, diversity, and appropriate local foods to be able to optimally feed their infants. Although infants were often weighed, their growth progress was rarely discussed with the mother. Effective growth monitoring should also include growth promotion, which includes dialogue with the mother in order to identify and address problem areas before they lead to growth faltering or malnutrition.
","“I feel that those who fully understand/grasp the counseling are most likely to exclusively breastfeed.” - District Nursing Officer Western Province“If you take a mother through one-on-one counseling, most will then exclusively breastfeed successfully.” - District Nursing OfficerWestern Province
","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","Urban|Rural","completed","01-2006","01-2011","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: IMAM
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: intergrated management of acute Malnutrition
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010In Eastern Cape Province, IYCN supported PATH’s efforts to improve the quality, availability, and uptake of PMTCT services by strengthening under-resourced PMTCT sites and mobilizing communities to increase the uptake of those services. To prevent malnutrition and ensure HIVfree survival of children, IYCN contributed to integrating infant and young child feeding activities into PMTCT interventions. Specifically, the project helped develop atraining package for lay counselors and community health workers and supported the training of 100 community health workers on infant and young child feeding. In addition, the project assisted the provincial health department to develop tools for surveying facility-based nutritionservices.By adapting a regional, community-based planning tool for use locally, IYCN worked with private-sector partner, J & J Trust, South Africa’s Ekurhuleni Municipality, and Ward 86 within the municipality’s Nigel District to conduct a pilot program that integrated nutrition interventions into economic and community development planning. This model approach can be scaled up throughout the district and beyond to enhance awareness of the nutritional status of young children and dietary and feeding practices that can improve their health. Through this approach, IYCN trained community volunteers to engage the community in nutrition activities. The community response was overwhelming, and community leaders included nutrition activities in development plans. These new activities included establishing a support group for pregnant and lactating mothers and their parents and initiating an awareness campaign on available structures to support lactation.
","x
","","x","x","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","The use of existing structures and processes made planning community nutrition activities and allocating resources feasible. The community in Ward 86 continues to implement nutrition activities based on their community development plans. Although the project did not fund the implementation of these activities, community leaders were able to leverage existing structures and resources.Engagement with communities revealed that people are aware of nutrition and related issues, but that technical support is needed to develop creative behavior change interventions. It is possible to build better linkages between the community and health services by engaging the municipal planning system.
","“I have seen the level of interest in nutrition in the community increase, and now ward members are empowered to influence the development plans of the municipality and the district to prioritize support for nutrition.”— Benny Sikhakhane, IYCN Project consultant
","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Providing maternal supplements of balanced energy and protein was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "11499","Food by Prescription","English","Community/sub-national","","ETH","Ethiopia","Addis Ababa, Ethiopia|Amhara, Ethiopia|Dire Dawa, Ethiopia|Harari, Ethiopia|Oromia, Ethiopia|Southern Nations, Nationalities, and People's Region, Ethiopia|Tigray, Ethiopia","Urban|Rural|Peri-urban","on-going","01-2009","01-2013","
For pre-antiretroviral treatment and antiretroviral treatment patients, clinical malnutrition is a risk factor for HIV and mortality. Malnutrition can also negatively impact birth outcomes among HIV-positive women. As HIV infection progresses, challenges to maintenance of adequate nutritional status—mal-absorption of nutrients, hyper-metabolism, etc.—increase and can adversely affect adherence to and effectiveness of drug treatments.
Food by Prescription provides food and nutritional support to malnourished HIV+ individuals in the form of therapeutic and supplementary feeding at health facility levels. The project serves severely malnourished people living with HIV/AIDS, HIV+ pregnant women, HIV+ women in their first six months post-partum, their infants, and orphans and vulnerable children. To ensure the program’s success, USAID works with the Ethiopian Ministry of Health and HIV/AIDS Prevention and Control Office, as well as the Food and Nutrition Technical Assistance (FANTA) project. Food by Prescription serves as a critical component of PEPFAR, a broader effort to strengthen integration of nutrition into HIV services. In order to reduce the cost associated with importation of nutrients and food commodities, the project will also collaborate with the public and private sector to explore the possibility of local production for some of the required food commodities.
Expected Results:
Two qualitative data collection rounds were included, with the following objectives:
a) Adherence and compliance: The objective of the first was to elaborate and contextualize the findings of the quantitative impact study, by exploring ration utilization and participant perceptions of the costs and benefits of participation in the FBP program. It sought to validate the assumption that participants were receiving and consuming the rations prescribed as per the program protocol and to identify the constraining factors and solutions for improved participant adherence. This component of the study also addressed issues of service provider participation, and the barriers and constraints to delivery that may have impacted the effects of the program on individuals.
b) Default and non-response: While the first qualitative study sought to identify constraints to adherence from a group of “successful” participants, a second study was designed to investigate the experience of “unsuccessful” participants, aiming to identify possible limitations to adherence among individuals who either defaulted from the program or failed to respond to the intervention.
The objective of the second qualitative study was to understand in greater depth the range of reasons for default among FBP program participants, as well as the range of reasons for poor weight gain among other participants.
The study was designed as a quasi-experimental effectiveness evaluation, with a comparison group of clinics selected from a geographic area similar to those in which the intervention was being evaluated. Originally, the study was designed to reflect the existence of a food support program being implemented by WFP in limited urban areas for households containing individuals with HIV. As the WFP program was providing a household ration to participant households, there was a concern that the measured impact of the FBP program could be biased by the presence or absence of the WFP program.
Therefore, the study sample was stratified to include three cohorts of participants who were followed longitudinally: two groups of adult PLHIV meeting FBP enrollment criteria in ART clinics at selected health facilities, one from sites offering both the FBP program and the WFP program, and another from sites offering FBP only. Participants from these two groups were recruited for the study at the time when they enrolled in the FBP program. The third group, a comparison group, was composed of FBP-eligible adults recruited from FBP Phase II sites, i.e., where the program had not yet been rolled out but would do so during Year Two of the program.
However, after the FBP program and the impact study had commenced, the WFP program was phased out. Despite this, the three study groups were maintained, with the idea that the two treatment groups could be pooled eventually if the baseline characteristics of the two did not differ significantly.
","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17803","","Management of severe acute malnutrition","","","","Preschool-age children (Pre-SAC)|SAM child","6-59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
OTP Outcome
Cured % (#)
> 75%
Died % (#)
< 10%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (June-Dec)
74.5 (1540)
0.7 (14)
6.9 (143)
17.9 (371)
Niamey (Aug-Dec)
83.3 (445)
0.4 (2)
3.6 (19)
12.7 (68)
Tahoua (Aug-Dec)
86.6 (453)
1.0 (5)
10.3 (54)
2.1 (11)
Tillaberi (Jan-Dec)
86.4 (912)
1.5 (16)
11.0 (116)
1.1 (12)
Zinder (Jan-Dec)
83.6 (799)
4.3 (41)
10.0 (96)
2.1 (20)
Reporting Period: Jan - Dec, 2011
Maradi
93.5 (4510)
0.3 (16)
4.9 (235)
1.3 (62)
Niamey
NA
NA
NA
NA
Tahoua
84.2 (1054)
0.8 (10)
5.8 (72)
9.3 (116)
Tillaberi
85.5 (1484)
1.6 (27)
10.8 (187)
2.1 (37)
Zinder
94.8 (1803)
0.5 (9)
3.2 (61)
1.5 (29)
Reporting Period: Jan - Dec, 2012
Maradi
97.7 (2651)
0.1 (3)
1.5 (41)
0.7 (18)
Niamey
86.9 (839)
0.3 (3)
5.4 (52)
7.5 (72)
Tahoua
84.7 (762)
1.6 (14)
10.4 (94)
3.3 (30)
Tillaberi
89.1 (886)
1.7 (17)
8.4 (83)
0.8 (8)
Zinder
98.8 (4200)
0.3 (12)
0.1 (6)
0.8 (32)
Reporting Period: 2013
Maradi (Jan-Apr)
94.6 (546)
0.5 (3)
3.3 (19)
1.6 (9)
Niamey (Jan-May)
70.1 (129)
0.0 (0)
18.5 (34)
11.4 (21)
Tahoua (Jan-May)
92.7 (281)
0.0 (0)
4.6 (14)
2.6 (8)
Tillaberi (Jan-Mar)
95.8 (46)
0.0 (0)
4.2 (2)
0.0 (0)
Zinder (Jan-May)
99.6 (1254)
0.2 (3)
0.1 (1)
0.1 (1)
","
Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805 ","Zinder: April-May 2007, point coverage = 21.4% and period coverage = 36.1%. ","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% MAY, 2013:TILLABERRI GAM 13.3%, SAM 3.1%ZINDER GAM 11.7%, SAM 2.3%MARADI GAM 16.3%, SAM 3.0%TAHOUA GAM 13.1%, SAM 2.3%NIAMEY GAM 11.0%, 1.6%","See above","Vulnerable groups","","Treatment of dehydration in children with severe acute malnutrition>>>Treatment of dehydration in children with severe acute malnutrition>>http://www.who.int/elena/titles/dehydration_sam","Supplies","Problem: There had been some difficulties in ensuring a consistent supply of RUTF. The nutritional commodities for the treatment of SAM are supplied via UNICEF through the MOH supply structure. But there were some challenges due to logistical and organisational issues, including the local/global availability of RUTF. Solution: WV established a buffer stock to resolve the issue. ","Supplies","Problem: A lack of consistent supply of medicines to the CSIs risks the increase in morbidity and mortality from illnesses such as pneumonia and malaria which are major causes of mortality in malnourished children. The care of children under the age of five are free in Niger. However, there are frequent shortage in medicinal supply. Because of the exemption of the fee and the system of cost recovery are in place, in principle UNICEF does not provide for the medicines for activities related to CMAM program although some spot supplies are available they are often inadequate. Solution: WVN is, already involved in the provision of medicines through the activities of ADP and, in case of need, the support will be intensified during this period of crisis. In addition to the routine medicines used for the treatment of the children admitted in the OTP, it would be important that WVN also considers to provide, in the event of rupture, the medicines needed to treat the pathologies associated with malnutrition.","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program.Solution: WV developed an Instituational Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities.Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff"," Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","","","","Zeinaba Abdoulahi lost her second child five years ago at the age of 4; his death is still a source of grief for this young Nigerien mother. Earlier this year, her fourth child, Tinoumoune, was close to death. The eight-month old girl was dehydrated and losing weight. After treating her with traditional herbal remedies, Tinoumoune continued to become physically weaker and weaker and had a fever for eight days. Zeinaba says “My child was between life and death. She was fading away. I had not a droplet of hope.” Zeinaba bundled her daughter on her back and left early in the morning to walk the seven kilometres from her village to the closest health centre, which runs a community-based management of acute malnutrition (CMAM) programme supported by World Vision. Tinoumoune was diagnosed with severe acute malnutrition and admitted to the nutrition programme, where she was treated with ready-to-use therapeutic food. “In two weeks, she regained weight and became stronger and healthier. I’m very happy.” explains Zeinaba. The family has been spared the grief of a second lost child.
©2010 Ann Birch/World Vision ©2010 Gebregziabher Hadera/World
Mma Halima is a CMAM community volunteer in Niger. She started in this role after caring for her own malnourished son until he graduated from World Vision's CMAM programme. Mma Halima screens and refers malnourished children in her nomadic community and provides health and nutrition education. She describes the ripple effect of her son's rehabilitation through CMAM: ""Now in my community all the mothers are using mosquito nets and our children are not getting sick as before. Now I have only two malnourished children in my community. It is impressive.""
","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17821","","Management of moderate malnutrition","","","","MAM child|Preschool-age children (Pre-SAC)","6 - 59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","SFP Outcome
Cured % (#)
> 75%
Died % (#)
< 3%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (Sept-Dec)
88.5 (491)
0.4 (2)
8.6 (48)
2.5 (14)
Niamey (Jan-Dec)
88.6 (194)
0.0 (0)
1.4 (3)
10.0 (22)
Tahoua (Aug-Dec)
86.4 (248)
0.0 (0)
13.6 (39)
0.0 (0)
Tillaberi (June-Dec)
88.4 (501)
0.7 (4)
10.2 (58)
0.7 (4)
Zinder (Jan-Dec)
90.8 (640)
2.6 (18)
5.4 (38)
1.3 (9)
Reporting Period: Jan - Dec, 2011
Maradi
97.0 (7069)
0.0 (3)
2.2 (162)
0.7 (51)
Niamey
85.8 (1949)
0.2 (5)
7.7 (175)
6.3 (143)
Tahoua
92.1 (1413)
0.0 (0)
6.3 (96)
1.6 (25)
Tillaberi
93.7 (4413)
0.2 (9)
5.1 (242)
0.9 (44)
Zinder
95.6 (4825)
0.4 (18)
2.4 (119)
1.7 (84)
Reporting Period: Jan - Dec, 2012
Maradi
99.0 (9559)
0.0 (0)
0.4 (38)
0.6 (54)
Niamey
81.3 (1886)
0.0 (0)
10.0 (233)
8.7 (201)
Tahoua
90.1 (984)
0.2 (2)
7.7 (84)
2.0 (22)
Tillaberi
88.7 (2065)
0.2 (4)
9.7 (226)
1.4 (33)
Zinder
94.9 (5508)
0.1 (3)
2.6 (148)
2.5 (143)
Reporting Period: 2013
Maradi (Jan-Apr)
97.1 (1501)
0.1 (1)
2.7 (42)
0.1 (2)
Niamey (Jan-Apr)
73.9 (241)
0.0 (0)
18.7 (61)
7.4 (24)
Tahoua (Jan-May)
88.7 (344)
0.0 (0)
9.0 (35)
2.3 (9)
Tillaberi
NA
NA
NA
NA
Zinder (Jan-May)
99.7 (2910)
0.0 (0)
0.2 (6)
0.1 (2)
","Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805","Zinder: April-May 2007, point coverage = 28.5% and period coverage = 49.0%.","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","See above","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","Supplies","Problem: The lack of a consistent supply of nutritional commodities for SFP has put children suffering from MAM at an increased risk for relapse, non-response, deterioration in status (into SAM) and defaulting. This lack of consistency has also negatively affected the credibility of the SFP program within the community. In turn, this has reduced the overall number of caregivers accessing the SFP services and thus has become a barrier to access.Solution: Contingency planning by the Food Commodity Department and logistics within WV to avoid stock shortage. For example add an extra percentage onto projected estimations each month in order to always have stock in place. ","Communication","Problem: The lack of clarity over the use of RUSF (Ready-to-Use Supplementary Food) and the target group has introduced increased risks for MAM cases in more vulnerable age groups. These cases were not being treated properly, thereby reducing effectiveness of the SFP program. Solution: Clarification with written protocols on the use of RUSF and other nutritional commodities for MAM and the target groups should be made available in the CSIs. It is also essential that there is community sensitization/awareness in the CSI catchment communities on the MAM aspect of CMAM.","External factors","Problem - Conflicting admission criteria: Community Volunteers (Femmes Relais) screen children for MAM in the communities using MUAC. However, upon arrival to the CSI/CS, the same children are admitted into the program on the basis of W/H criteria (outlined in National Protocol). Due to the discrepancies between W/H and MUAC screening, children are rejected from the program. This can reduce the effectiveness of community mobilization because of the problem of rejection.Solution: In order to increase coverage of the program a mass screening was carried out in the 5 regions covered by WV. Over 40,000 children were screened which resulted in a subsequent increase in the SFP admission. ","External factors","Problem: Distance as a barrier to access. Some of the CSI are located very far from the communities that they are serving. Solution: Expand MAM treatment (i.e. SFP) to Health Posts (CS) in order to reduce distance travelled for beneficiaries thus helping to improve the program accessibility as well as reducing the work load in CSIs (however the program capacity must be assured before decentralising these services to health posts).","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program. Solution: WV developed an Institutional Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities. Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff","Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","01-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17823","","Food distribution/supplementation for prevention of acute malnutrition","","","","Lactating women (LW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS","","Zinder, Maradi, Niamey, Tahoua","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17824","","Nutrition education and counselling","","","","Adolescents|Adult men and women|Elderly|Family ( living in same household)|Females|Lactating women (LW)|Males|Non-pregnant women (NPW)|Non-pregnant, non-lactating women (NPNLW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS|Women of reproductive age (WRA)","","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","Once the main components of the CMAM programme (e.g. OTP and SFP) have been well implemented in the existing MOH and community structures, a focus was given to address the negative behavioural and adaptive issues around IYCF in order to prevent further malnutrition. Depending on the priorities and funding availability, some ADPs were able to integrate IYCF activities in the CMAM. These included carrying out weekly health and nutrition session on CMAM days at the CSIs (Health Centers) and reactivating PD Hearth approach to develop menus using new types of locally available foods for complementary feeding promotion. Additional objectives of IYCF included strengthening existing nutrition systems and capacity building through training of health workers and community volunteers on IYCF and carrying out a baseline survey on IYCF and quarterly monitoring of changes in behaviour (e.g. EBF rates, diversity of food groups in complementary feeding). However, apart from the weekly nutrition education sessions at the CSIs, some of the activities did not translate into action at the community level. For example, the training of national WV staff on IYCF did not cascade down to the community level with community volunteers and also did not translated into activities or development of monitoring tools at community level. Additionally, no baseline IYCF information was available and quarterly monitoring data had not been collected or was unavailable at community level.
NB: This program was funded for a year therefore continuation of the activities beyond the funding period is likely be sporadic as it will depend on various factors including staff and volunteer capacity and motivation.
","For Tillaberi and Niamey regions in July 2010-July 2011:
Nutrition education (incl. IYCF): Target 24,700; Achieved (by the 3rd quarter) 14,234
Number and percentage of infants 0-6 mos who are exclusively breastfed: Target 310 (10%); Achieved N/A
Number and percentage of children aged 6-24 mos who receive foods daily from 4 or more food groups: Target 3045 (40%); Achieved N/A
","Due to a lack of monitoring and reporting it was not possible to report on Infant and Young Child Feeding activities apart from nutrition education sessions at the health centers even if these activities had been occurring in an informal manner in the communities. But it appears that these activities had been strengthened and expanded towards the end of the programme cycle.
","See outcome indicator section","NA","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","Same as above","Vulnerable groups","","","Management","","","","","","","","","","","","","","","","","","","","","WV Niger’s implementation of IYCF activities into the ongoing CMAM program started late in the program period. Due to the high resource (human & financial) intensity of implementing a CMAM program, it was not feasible to introduce IYCF activities until the latter program stages. At the beginning of the program, the MOH staff were trained in providing nutrition education sessions at CSIs on OTP/SFP days which included IYCF messages. Later on, national WV staff were trained on IYCF with the aim that they would cascade this training to the ADP level and then to the community level. However, the training did not continue to the community level (with community volunteers) until near end of the program period.
To strengthen IYCF component of CMAM including monitoring activities, the following activities are recommended:
1. Recruit community mobilisers at ADP level who will work with district Community Focal Points, WV ADP and National Community Mobiliser. The lack of WV community mobilisers at ADP level to work alongside the Nutrition Coordinators has risked a delay in training community volunteers and may have also prevented the implementation of community mobilization activities including IYCF activities and monitoring of these activities.
2. Ensure women are represented in nutrition programs. During the IYCF investigation the 50/50 presence of women as interviewers for the IYCF investigation ensured better access to women and thus the provision of more rigorous information regarding IYCF practices.
3. Develop monitoring tools for IYCF. E.g. How many IYCF sessions held and how many participated?
4. Carry out a representative and statistically significant baseline and final IYCF survey – for EBF rates and diversity of food groups.
","","English"