An assessment of the causes of malnutrition in Ethiopia: A ...
An assessment of the causes of malnutrition in Ethiopia: A ... An assessment of the causes of malnutrition in Ethiopia: A ...
Table 6.6: (continued) Agency Intervention Status Timeframe Main areas Objectives Activities Target Sites Médecins Sans Frontières - Switzerland Health assistance for vulnerable populations active Short term, but closure date uncertain Therapeutic feeding for severe acute malnutrition using m obile health clinics Mortality reduction Antenatal care, delivery care, post-natal care, vaccinations, sick child consultations, nutritional surveillance. N/A Gambella region Roles definition Combination of MOH staff, who receive incentives under the project, and MSF staff. No volunteers at present. Partners Training Tools developed Achievements Challenges Sustainability MOH None None 100 severely malnourished children treated in the refugee camp. • Gambella region health system has very low capacity. • Poor level of health knowledge and general education in the community. Lack of knowledge about treatment benefits of therapeutic feeding in the community is a threat to sustainability. Lessons learnt Health and nutrition problems of Gambella region have been badly impacted by the security problems in the past 18 months . Insecurity has caused large and ongoing displacements of people. 188
Table 6.6: (continued) Agency Intervention Status Relief Society of Tigray (REST) Community based health care promotion. Active Timeframe 2000-2007 Main areas Prevention of illness. Objectives Increase access of targeted communities to basic health services . Activities Target Sites • Antenatal care: physical examination, health education, iron/folic acid distribution (depending on availability, in fact rarely conducted), breastfeeding counseling. • Delivery care: delivery by health professionals, Traditional Birth Attendants (TBAs) training and kits supply, with gloves distribution for HIV prevention. • Post-natal care: consultation including family planning, child and mother examination, Vitamin A within 6 weeks from delivery, breast-feeding counseling, complementary feeding, food preparation demonstrations, and growth monitoring and promotion (weighing, plotting, evaluation, counseling). • Vaccination: EPI, tetanus toxoid (routine and monthly outreach). • Healthy child consultation: Health facility-based growth monitoring, maternal and child health and nutrition education, vaccination. • Sick child consultation: health facility-based and outreach (case screening and referral to health facility), physical examination, laboratory investigation, essential drugs provision, growth monitoring, EPI vaccination status check. • Nutritional surveillance: growth monitoring for under-fives (routine and outreach), population survey twice a year and in case of drought or other emergency, contributing factors are discussed with the community to identify solutions. • Food distribution: Supplementary feeding for demonstration purposes , including 3 kg monthly ration for moderately malnourished child until recovery. Provided with maternal education on locally available foods (eggs, milk) and their preparation. Mothers and under-fives , adolescent girls. Five woredas in Tigray. Health facility-based and monthly outreach in communities that are located more than 5 km from a health facility. Roles definition Health bureau, woreda coordination office, and health structures (both static and outreach). Community health agents, community reproductive health agents, TBAs Partners Training Tools developed Achievements Challenges Sustainability Communities, MOH (woreda health office and Family Health Department) TBAs receive 30 days of training, Community Reproductive Health agents - 15 days, Community Health Volunteer (CHV) - 45 days. CHVs also undertake an annual needs assessment exercise leading to refresher training (3-7 days practical, on-the-job training). Training manuals, posters, and flip charts for CHVs on nutrition; STIs, including HIV prevention; environmental health; maternal and child health; and breastfeeding. N/A • Resource constraints. • Lack of integrated service package: fragmentation in activity financing due to donor constraints . Acti vities are more sustainable where integrated. Conversely, lack of integration leads to uninterested communities, as they do not see results. Lessons learnt • Integrated nutrition-focused interventions bring impact on the household. Integration defined as the same service package regularly available to all target population in target territory. • Child growth monitoring as effective entry point for vaccination and nutrition education. 189
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Table 6.6: (cont<strong>in</strong>ued)<br />
Agency<br />
Intervention<br />
Status<br />
Timeframe<br />
Ma<strong>in</strong> areas<br />
Objectives<br />
Activities<br />
Target<br />
Sites<br />
Médec<strong>in</strong>s Sans Frontières - Switzerland<br />
Health assistance for vulnerable populations<br />
active<br />
Short term, but closure date uncerta<strong>in</strong><br />
Therapeutic feed<strong>in</strong>g for severe acute <strong>malnutrition</strong> us<strong>in</strong>g m obile health cl<strong>in</strong>ics<br />
Mortality reduction<br />
<strong>An</strong>tenatal care, delivery care, post-natal care, vacc<strong>in</strong>ations, sick child consultations,<br />
nutritional surveillance.<br />
N/A<br />
Gambella region<br />
Roles def<strong>in</strong>ition Comb<strong>in</strong>ation <strong>of</strong> MOH staff, who receive <strong>in</strong>centives under <strong>the</strong> project, and MSF staff. No<br />
volunteers at present.<br />
Partners<br />
Tra<strong>in</strong><strong>in</strong>g<br />
Tools<br />
developed<br />
Achievements<br />
Challenges<br />
Susta<strong>in</strong>ability<br />
MOH<br />
None<br />
None<br />
100 severely malnourished children treated <strong>in</strong> <strong>the</strong> refugee camp.<br />
• Gambella region health system has very low capacity.<br />
• Poor level <strong>of</strong> health knowledge and general education <strong>in</strong> <strong>the</strong> community.<br />
Lack <strong>of</strong> knowledge about treatment benefits <strong>of</strong> <strong>the</strong>rapeutic feed<strong>in</strong>g <strong>in</strong> <strong>the</strong> community is a<br />
threat to susta<strong>in</strong>ability.<br />
Lessons learnt Health and nutrition problems <strong>of</strong> Gambella region have been badly impacted by <strong>the</strong><br />
security problems <strong>in</strong> <strong>the</strong> past 18 months . Insecurity has caused large and ongo<strong>in</strong>g<br />
displacements <strong>of</strong> people.<br />
188
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