Action - Nutritional Improvement for children in urban Chile and Kenya (NICK) Project - Complementary feeding promotion and/or counselling - Infants (up to 1 year of age)|Infants and young children|Preschool-age children (Pre-SAC)

Programme: Nutritional Improvement for children in urban Chile and Kenya (NICK) Project

Programme description

NICK (Nutritional Improvement for children in urban Chile and Kenya) is a three year study that started in October 2010 with funding from the UK Government Department for International Development (DFID) through the Economic and Social Research Council. This study helps the cities of Mombasa in Kenya and Valparaíso in Chile reduce child malnutrition using participatory action research to broaden stakeholder participation at municipal level to change the social determinants. These determinants control the everyday conditions in which people are living and include education, income, working conditions, housing, neighbourhood and community conditions, and social inclusion. It is envisaged that this study will contribute to existing knowledge and also serve as a useful guide for action not only in Kenya and Chile but also in other countries with high levels of child malnutrition.

The NICK project is being implemented in one Mombasa informal settlement (with one matched control settlement). The project, which started on October 1st 2010 and ends on September 30th 2013, is guided by the following central question: Can child malnutrition amongst families living in poverty in informal settlements and slums in Mombasa and Valparaíso be reduced through broadening community and stakeholder participation to change the social determinants of nutritional status?

The project seeks to address the following research questions:

  1. What are the social determinants of child malnutrition?
  2. How effective are any policies, initiatives and networks that are already in place in influencing these determinants in the informal settlements?
  3. What are the constraints on the effectiveness of these policies, initiatives and networks in the selected sites?
  4. What are the actions, pathways and mechanisms (including those in existing structures) through which broadening community and stakeholder participation can be made most effective in reducing child under-nutrition in a sustainable way?
  5. What are the main implications and lessons learned for policy development and implementation at scale in the project countries and for other countries?

Programme type

Multi-national

References

Status: 
On-going

Start date:

January
2010

End date:

January
2013
Area: 
Urban
Place: 
Chaani (intervention) and Kongowea (control)
Target group: 
Infants (up to 1 year of age)
Infants and young children
Preschool-age children (Pre-SAC)
Age group: 
Every child up to 5 years
Delivery: 
Community-based
Implementation details : 

 Given the recognition that the determinants of child malnutrition are systemic and require multi-disciplinary concerted efforts to address, the Kenyan research team decided to explore ways of ensuring that the project is integrated into the national efforts that focus on child nutrition. The initial steps, therefore, involved holding discussions with the Nutrition Division in the Ministry of Public Health and Sanitation (MOPHS). During these discussions (in January 2011), it emerged that there are multiple efforts being put in place to strengthen interventions on child malnutrition and related problems among the urban poor. One such initiative was the proposed formation of Urban Nutrition Working Groups (UNWG).

The Kenyan NICK team considered that establishing an UNWG in Mombasa was critical entry point that would help to make NICK activities an integral part of local initiatives with a high possibility of sustainability. This UNWG would function as the participatory action research (PAR) group that was needed for the NICK Project. The team, therefore, sought the support of the national nutrition office to do the following:

  1. Facilitate the formation of the Coastal UNWG;
  2. Conduct a baseline survey on child nutrition in informal settlements of Mombasa;
  3. Identify key social determinants and engage with UNWG in defining interventions with immediate, medium and long-term impacts;
  4. Implement some interventions (to be determined by the UNWG) towards addressing some of the identified determinants; and
  5. Evaluate the impacts of the interventions at the end of 12 months of implementation.

Following the granting of permission to work with the Provincial Nutrition Officer, several meetings were held in Mombasa to plan for an initial meeting with local stakeholders to introduce the project and form a Participatory Action Research (PAR) group. The agreement was that the UNWG would also serve as the PAR group. The research group also met with Dr. Shariff,3 the Director of Medical Services, in the Ministry of Public Health and sanitation (MOPHS) who was supportive of NICK and emphasized the need for the project to enhance the implementation of national nutrition priorities. The team also met with members of the Kenya Food Security Steering Group (KFSSG) who had just completed a national survey on Urban Food Security.

The preparatory phase was also utilized to carry out literature reviews and interviews to consolidate the situational analysis. A research permit was acquired, which was granted by the National Council for Science and Technology. With this permit, the Kenyan research team was able to plan for the baseline survey.

(i) Formation of the Provincial Nutrition Technical Committee and UNWG
This meeting was held in Mombasa on April 29th 2011. It brought together 24 participants who were drawn from the participating government departments and other partners. During this meeting, the team agreed to form the Provincial Nutrition Technical Committee under the leadership of the Provincial Nutritionist. Thirteen members were also nominated to form the UNWG under the leadership of the District Nutrition Officer. The members were supportive of this group due to the potential to have a coordinated approach to addressing child nutrition in the region.

(ii) Conduct of the baseline survey
During the initial meeting, it was agreed that the UNWG would be involved in carrying out the baseline survey. As part of community service, the members agreed that anthropometric measurements would be done for every child up to 5 years in the two study sites of Chaani (intervention) and Kongowea (control). Over 900 children were weighed and measured. Data from children 12-59 months indicate higher than national averages for stunting, with Chaani worse off than Kongowea.
The KDHS indicates high levels of stunting and underweight in the Coastal Province.

A household baseline survey was conducted (between June and July 2011) during which over 800 households were interviewed. The main issues addressed were child nutrition, health seeking behaviour and coping mechanisms. Data analysis is ongoing. The Kenyan team is now facilitating the UNGWA through three 6-monthly cycle of action and reflection to develop, implement and improve a range of small scale multisectiorial action to change the social determinants of child undernutrition.

(iii) 1st UNWG/PAR workshop – July 2011
This was a three-day meeting that was attended by 16 participants including the London-based researchers. A follow-up meeting for the UNWG was held on 20th July during which the first multisectorial action plan was finalised.

(iv) Community level activities
Community sensitization is ongoing. The UNWG has held meetings with health officials and village elders in Chaani (the intervention site). A public meeting was held with the community members on 7th November 2011, which was attended by over 250 people. So far 17 formalized groups have been identified and the next steps are to assess the training and research needs of these groups. Support for this group, in the form of training and provision of seed funds will be initiated in January 2011.

 

 

 

Coverage level (%): 
Over 800 households; Over 900 children
Outcome indicator(s): 
  • Underweight
  • Stunting

 

Baseline: 
Anthropometric measurements
Outcome reported by social determinants: 
Vulnerable groups

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Revision log

DateUserLogState
Tue, 03/11/2014 - 16:22engesveenkEdited by william_nkoom.published
Wed, 02/26/2014 - 15:05engesveenkEdited by william_nkoom.published
Wed, 02/26/2014 - 14:31engesveenkEdited by william_nkoom.published
Wed, 02/26/2014 - 13:59engesveenkEdited by william_nkoom.published
Wed, 03/27/2013 - 16:15bloessnermEdited by william_nkoom.published
Sat, 02/02/2013 - 22:58william_nkoomEdited by william_nkoom.draft
Wed, 01/30/2013 - 14:26AnnaLarteyEdited by AnnaLartey.needs_review
Wed, 01/30/2013 - 10:05AnnaLarteyEdited by AnnaLartey.draft
Mon, 01/28/2013 - 15:53AnnaLarteyCreated by AnnaLartey.draft