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Lessons in the Integration of CMAM & IMCI Activities_Diene_5.12.11
 

Lessons in the Integration of CMAM & IMCI Activities_Diene_5.12.11

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    Lessons in the Integration of CMAM & IMCI Activities_Diene_5.12.11 Lessons in the Integration of CMAM & IMCI Activities_Diene_5.12.11 Presentation Transcript

    • Food and Nutrition Technical Assistance II Project (FANTA-2)
      Academy for Educational Development 1825 Connecticut Ave., NW Washington, DC 20009
      Tel: 202-884-8000 Fax: 202-884-8432 E-mail: fanta2@aed.org Website: www.fanta-2.org
      Integration CMAM into National Health Systems
      Serigne M. Diene
      FANTA-2 Senior HIV and Nutrition Advisor
    • PLAN
      Background
      Analytical framework for integration
      Integration CMAM into national health systems: country experiences and challenges
      Key lessons learned
      Enabling environment
      Competencies for CMAM
      Access to CMAM services
      Access to CMAM equipments and supplies
      Quality of CMAM services
      Way forward
      2
    • BACKGROUND
      Review CMAM program implementation and its integration into national health systems
      Countries : Burkina Faso, Mali, Mauritania, Niger
      Highlight lessons learned and make recommendations on challenges, best practices, gaps
      Methods : documents review, country visits
      3
    • ANALYTICAL FRAMEWORK
      4
      KEY ELEMENTS OF CMAM FALL IN FIVE DOMAINS
    • ANALYTICAL FRAMEWORK (2)
      5
      COMPONENTS OF CMAM
    • Integration into routine health and nutrition services: Examples
      Burkina Faso
      Essential Nutrition Actions (ENA) (same CHW)
      Growth Monitoring and Promotion (GMP)
      Community IMCI not evident
      Mali
      ENA
      12 Family Practices
      GMP (?!)
      SIAN (Week of Intensified Nutrition Activities)
      6
    • Integration into routine health and nutrition services: Examples (2)
      Mauritania
      CMAM linked with Child Survival Weeks
      CMAM linked with IMCI
      CMAM linked with Reproductive Health initiatives
      Niger
      Great political will and support for integration
      Focus on activities only (not yet resources not)
      GMP (?!)
      Baby Friendly Hospital Initiatives (BFHI)
      IMCI
      7
    • Integration into routine health and nutrition services: Challenges
      • Weak health systems
      • Insufficient training for health workers
      • Inadequate supply flow
      • Need to integrate at clinical levels as well as Community-IMCI
      8
    • KEY LESSONS LEARNED
      Enabling Environment
      High level commitment not yet translated into concrete action plans for scale up and quality improvement
      Community outreach components to be strengthened: role of community health workers to be defined and structured
      Specific CMAM technical expert/unit/system needed for strong institutional capacity and quality services, including MOH technical leadership
      9
    • KEY LESSONS LEARNED (2)
      Competencies for CMAM
      Training skills, quality of training tools, mentoring to be improved for in-service training
      Financial and technical support for pre-service training
      Need for effective learning sites and national high-level expertise for CMAM quality improvement
      Formalized documentation and dissemination of Best practices and lessons learned
      10
    • KEY LESSONS LEARNED (3)
      Access to CMAM services
      Sustainable and affordable community outreach is still missing. Need for shared experiences on most promising approaches
      M-MAM increasingly linked to food security and prevention services and not always with M-SAM
      Human resource shortage limits high coverage in Outpatient Care
      Importance of good referral and counter referral system, need to be part of training
      Linkage with informal health sector as part of training, supervision and mentoring
    • KEY LESSONS LEARNED (4)
      Access to CMAM equipment and supplies
      Improving and integrating CMAM procurement and supply systems should be a priority
      Quality of CMAM services
      Support of national and international experts (academic and practical) for standardized guidelines based on best practices (Ex : Issues of use of MUAC as admission criteria, Vitamin A administration, early referral to outpatient care after stabilization )
      Standardized training materials and job aids to be made available
      Systems of quality improvement to consider
    • WAY FORWARD
      Improve quality of services delivery and access, building on decentralization of process
      Use of integrated approach is gaining momentum that should be boosted
      Linking in-service to pre-service training resources and competencies should be a more common practice
      13
    • This presentation is made possible by the generous support of the American people through the support of the Office of Health, Infectious Disease, and Nutrition, Bureau for Global Health, and the Office of Foreign Disaster Assistance, Bureau for Democracy, Conflict and Humanitarian Assistance of the United States Agency for International Development (USAID) under terms of Cooperative Agreement No. GHN-A-00-08-00001-00, through the Food and Nutrition Technical Assistance II Project (FANTA-2), managed by the Academy for Educational Development (AED). The contents are the responsibility of AED and do not necessarily reflect the views of USAID or the United States Government.
      Food and Nutrition Technical Assistance II Project (FANTA-2)
      Academy for Educational Development 1825 Connecticut Ave., NW Washington, DC 20009
      Tel: 202-884-8000 Fax: 202-884-8432 E-mail: fanta2@aed.org Website: www.fanta-2.org