Download PDF - Field Exchange - Emergency Nutrition Network

EvaluationThe materials have been used more broadly thanintended – half of respondents used the materialsin non-emergency contexts. Only one quarterused them to train practitioners – this may reflectalternative uses, the need for more specific targetingof the materials, or a lack of training skillsamongst the users.Content of materialsThe survey confirmed that the materials providepreviously unavailable technical information tofield practitioners. A number of respondentsdescribed some of the content as ‘unique’ and fillinga gap in information. However, there was acall to further simplify the text. A number ofrespondents also raised the appropriateness ofthe materials (particularly pictorial representation)in places where cultural taboos aroundbreastfeeding exist.Respondents highlighted gaps in informationnot covered by the materials. Infant feeding inthe context of HIV and AIDS, and complementaryfeeding were considered priority areas. Othersuggestions included:• Practical advice on how to handle organisationshanding out infant formula/baby milk• Include a section ‘20 frequently askedquestions’ on infant feeding in emergencies• Community preparedness for emergenciesin terms of infant feeding (considered particularly relevant for Latin America)• Related human rights and humanitaria laws.Accessibility of materialsThe survey revealed the need to make the materialsaccessible to a wider audience. There wasclear demand for the modules to be translatedinto other languages (including French, Spanishand Italian). Other formats that may be more easilydistributed were suggested, e.g. as a powerpoint presentation and as a book. Although CDformat could improve access considerably, it hasbeen under utilised as a means of distribution 1 .Respondents also suggested holding trainingworkshops.Planning, Monitoring and EvaluationAnalysis of the project as a whole revealed a lackof clearly defined targets and indicators. The distributionof materials was adequately monitoredby ENN, however the system to monitor webdownloads needs improving. There is also nosystem to track dissemination by IFE Core Groupmembers other than ENN. It is still early days butsubsequent evaluations may reveal more aboutthe long term impact of the training modules.RecommendationsSpecific recommendations from the evaluationinclude:• Marketing the materials to a wider range oforganisations, including international NGOsand donors, technical and nontechnical staff.Box 1“At the end of 2005 I was informed that a churchorganisation had written a letter to the Ministry ofHealth (MOH) offering to provide free infant formulato distribute to all artificially fed infants incountry starting from 9 months of age. I spoke onthe phone to the head of the MOH departmentand reminded her of the previous experience inour country when breastfeeding rates decreased3 times because of the free formula supply, and Ialso reminded her of the provisions of theInternational Code. She suggested that I write astatement to this effect to the MOH, so that theycould use it when answering the letter, which of• Revision of the materials on the basis of newevidence in priority areas, such as infant feedingin the context of HIV and AIDS and themanagement of severely malnourished infants.• Future updates should consider the adaptedmaterials developed by users in future versionsof the modules, refine the text, anddevelop versions applicable where culturaltaboos may exist.• Highlight resource gaps that do not fall withinthe remit of the IFE Core Group to otherpartners and organisations that might be willingto produce them.• Consider developing new materials on priorityareas, such as complementary feeding inemergencies. Engage in a deeper process ofconsultation with stake-holders to decide onpriority areas.• Translation of the materials into other languages, develop and market the CD formatmore widely, and consider producing futuredrafts of the modules in a more cost-effectiveformat.• Hold regional workshops to orientate userson applying the modules.• Define plans, including targets, objectives,outputs and indicators for the next stage ofthe project.• Set up systems to monitor downloads fromthe ENN website and to track the secondarydissemination of materials through IFE CoreGroup members.Follow-upSince the evaluation, the ENN has begun toaddress a number of the recommendations,including developing a better system to monitordownloads from the ENN’s website, and direct‘marketing’ of the materials to NGOs and donors.A number of the issues highlighted in the evaluation,such as developing training materials oncomplementary feeding in emergencies, updatingthe materials to reflect developing areas likeinfant feeding in the context of HIV and AIDS,and translation of the materials, have long beenidentified as priority work areas by the IFE CoreGroup. A perquisite to seeing these recommendationsthrough is the identification of resources tosupport IFE activities. This will be one of themain outcomes sought at of the IFE orientationworkshop scheduled in November 2006 (seenews section in this issue).A full copy of the evaluation is available from theENN. For further information on the trainingmodules or the November meeting, (see newspiece, p14) contact the IFE Core Group c/o MarieMcGrath, ENN, email: ife@ennonline.net1Large sections of Modules 1 and 2 have been included on therecently completed TALC CD on community nutrition. Fordetails, see www.talc.orgcourse I did. I referred to Module 1, section 2.4'Donations of infant formula in emergencies canbe dangerous’, Section 3.1 'The InternationalCode of Marketing of Breastmilk Substitutes(BMS)' and Annex 1 'The International Code ofMarketing of BMS – summary of portions relevantto emergencies'. I was told informally that my letterwas shown to the deputy minister and wasused while answering the letter of the churchorganisation. Their answer was negative. Thechurch organisation also intends to change itspractices and in future support breastfeeding. Soyou can see that the materials were quite useful.”T Krumbein, Uganda, 2005LocallyproducedRUTF in ahospitalsetting inUgandaBy Tina Krumbein,Veronika Scherbaum,and Hans Konrad BiesalskiA mother spoonfeedsher baby in the NUTina Krumbein is a graduatenutritionist. Thisarticle forms part of herdiploma thesis submittedto the Departmentof Biological Chemistyand Nutrition, Universityof Hohenheim, Germany.Veronika Scherbaumholds a MSc degree inMother and Child HealthNutrition. Since 1998,she has been a lecturerin Nutrition inDeveloping Countries atUniversity of Hohenheim, Germany. Inthe 1980s she worked for several yearsin Ethiopia as a nutritionist. More recently,she has been involved in consultancies(mainly for evaluation of SFPs, TFPs andbreastfeeding promotion) in Afghanistan,Iraq, Zimbabwe and Darfur.Hans K Biesalski is director of theDepartment of Biological Chemistry andNutrition. He is actively involved inresearch on vitamin A metabolism and issupervisor of studies in InternationalNutrition. He is a member of IVACG andchair of a couple of studies dealing withVitamin A Deficiency Disorders (VAD).This pilot study was financially supportedby the Eiselen Foundation, Ulm and theGerman Medical Missionary Team.T Krumbein, Uganda, 2005Food storage roomin the Nutrition UnitField respondent to evaluation, 2006.21