Overview:
WR has been implementing PD/Hearth in Rwanda as part of
USAID- funded Child Survival Program since 2006, and Care Groups since 2001.
The Innovation CSP in Nyamagabe District is combining these two methods in a
further evolution of PD/Hearth called "Nutrition Weeks."
The
purpose of Nutrition Weeks is broader than rehabilitation of under-nourished
children; instead all mothers of children in their first 1,000 days of life are
invited to participate in the hands-on education program aimed at
preventing under-nutrition. The aim is to improve the nutritional status of
pregnant and lactating women, as well as children between 0-23 months old
through enhanced Infant and Young Child Feeding (IYCF) practice.
Community Health Workers are trained and given a
step-by-step guide to implementing Nutrition Weeks. Per MOH suggestion, these
weeks will be held three times a year. The Operations Research component
of the Innovation CSP aims to identify
the most feasible way to reduce and prevent under-nutrition in the first 1000
days of life of children in Nyamagabe District, Rwanda through formative
research, and then to test the
innovated intervention, namely, “Nutrition
Weeks” to evaluate if the intervention is more effective than the standard
CBNP (Community-based Nutrition Program), which are cooking demonstrations.
The objective of this program is for mothers to learn about nutritious
foods that they may not be giving children, optimal feeding practices and other
health behaviors to prevent under-nutrition. The sessions last for 2 hours
daily of hands-on practice for one week, with follow-up by specially-trained
volunteers.
Reasoning for Innovation:
The Standard Community Based Nutrition Program used in
Rwanda now teaches mothers what to feed their children with cooking
demonstrations. Nutrition Weeks adds a hands-on practice and discussion, also
involving mothers in law and fathers on certain days. The counseling, home visits, and other
activities show the mothers how to practice these new skills. The peer support
is also built in, as all the mothers in a village learn together in small
groups.
Positive Deviance Inquiry (PDI):
A series of semi-structured interviews and observations were
carried in the Kaduha zone by a team of 2-3 ICSP staff using a PDI approach to
acquire information about child feeding and heath care practices. Both
positive and negative deviant mothers were interviewed in order to adapt the
program the community needs. The findings from the positive and negative
deviant household interviews were compared to the identified positive behaviors
that could be broadly applied to the community.
Unlike a typical PDI approach this process was not repeated
in every village where the intervention is being implemented. Rather, the
results from the PDI was utilized to develop the Nutrition Week Curriculum.
Population/ Area:
The Nyamagabe district was chosen as a whole for the project
based on government priority as well as to be able to build on the foundation
of work with the CHWs that was established during EIP. The comparison and
intervention groups were divided based on the hospital zones (Kigeme and
Kaduha). Both hospitals were very similar; however Kaduha was chosen for
intervention because it had slightly worse indicators.
Each Nutrition Week was held in the house of one of the
community members. The house was chosen based on a criteria list to ensure the
site would meet all the needs of a Nutrition Week.
Training/ Orientation:
There were three primary training/orientations:
- Master Trainer Orientation
- Training of Trainers (TOT)
- Training of Village Nutrition Committees
Supervision of Nutrition Week
Supervision of Nutrition Weeks is performed by health staff,
health facilities staff, and ICSP Staff.
No comments:
Post a Comment