Action - National Nutrition Programme/Community-based Nutrition (NNP/CBN) - Food distribution/supplementation for prevention of acute malnutrition - Infants and young children|Preschool-age children (Pre-SAC)

Programme: National Nutrition Programme/Community-based Nutrition (NNP/CBN)

Programme description

The Government of Ethiopia launched the National Nutrition Programme (NNP) in 2008. NNP has many relevant components to reduce the magnitude of malnutrition in Ethiopia by reorienting the focus away from emergency and food security interventions and mainstreaming nutrition into community-based health and development programmes. Key nutrition activities of the NNP include:

1. Health Extension Programme (HEP): The core strategy for universal primary health service coverage. It aims to improve family health status through disease prevention and control at the community level 

2. Promotion of Essential Nutrition Actions

3. Therapeutic Feeding Programme (TFP): Children with complicated SAM receive care through therapeutic feeding units, and children with uncomplicated SAM are managed in the community through Outpatient Therapeutic Programmes (OTP) at decentralized sites. There are more than 5000 OTP sites across 200 woredas.

4.  Enhanced Outreach Strategy (EOS)/ Extended Enhanced Outreach Strategy (EEOS) and Targeted Supplementary Feeding (TSF).

5.  Community-based Nutrition (CBN). The CBN was launched in 2008 and will expand to cover 35% of Ethiopia’s total population (228 woredas). CBN is focused on children under two and uses monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems, analysing causes of these problems, taking action and monitoring progress.

Quarterly screening for acute malnutrition through Community Health Days

Referral of severely underweight children to Therapeutic Feeding Programme (TFPs) and/or Targeted Supplementary Feeding (TSFs) as required;

Programme type

Large scale programmes

Cost

CBN: Intensity of Community health workers (CHWs) is about 1:23 children, estimated as 0,2 Full-time equivalents (FTE), i.e. 86:1000 households. Per capita costs are not available.HEP: Government of Ethiopia aimed for a ratio of 1 health extension worker (HEW):2500 persons, and 1 health post:5000 persons. Government of Ethiopia spending on health is only 7.5% of the total government budget,and total per capita public health expenditure was US$ 3.00 in 2008, below the target expenditure of US$ 4.80 per capita estimated for full implementation of the HEP.

References

WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of NNP/CBN is retrieved from the ENA Part II where NNP/CBN is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated. 

http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/

Status: 
On-going
Target group: 
Infants and young children
Preschool-age children (Pre-SAC)
Delivery: 
Community-based
Implementation details : 

Internal provision supplementary feeding for severely underweight children.

Target population size : 
86 % of wordeas
Coverage level (%): 
Population coverage in target areas (now approximately 250/640 woredas (districts)) is approximately 40%
Outcome indicator(s): 

Underweight

M&E system: 

Initial analysis of routine programme data from 1.5 million under-2 children weighed in 4 regions showed a decline in underweight from 30% in January 2009 to 20% in March 2010

Post-intervention: 

Participants' initial rate of underweight reduction: 8.0 ppt/year. Participants’ sustained rate of underweight reduction: 5.0 ppt/year, with estimated 40% coverage this gives a sustained population rate of 2.0 ppt/year.

Revision log

DateUserLogState
Thu, 03/22/2018 - 14:17engesveenkCopy of the revision from Wed, 11/26/2014 - 16:00.published