Care Groups and Integration


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  • Haiti MYAP 2008-2013
    At midterm evaluation dropped our H&N nutrition partner and took on the implementation of that component
    Switched from traditional mother support groups to MCGs
    Focus on integration—particularly agriculture for PLW participating in MCGs. This did not include explicit integration of H&N messaging into farmers’ training

    At end of project conducted focus groups with MCG participants and farmers group participants in 4 different communes (Belle-Anse, Grand-Gosier, Cote de Fer, Thiotte) within the SE department to examine (1) how/to what degree H&N participants received ag training/messaging and ag participants received H&N training and (2) what type of information was shared out the hh level where members of the same hh participated in both components
  • Goats—kids dispersed to other LMs in a loan cycle
    Kitchen garden trainings 4-8 hrs a month, 3 times a year. Women indicated that this greatly improved their hh nutrition because they not only learned about good nutrition, but they grew crops to meet those requirements, and both they and the farmers’ groups learned about the ratio of eating ¼ of the crop, selling ½, and saving ¼ for seed. Women also noted that they felt that this ag training, and the increased production that they could now bring to market, helped to connect them to their larger community

    Sustainability: this is not an integration issue, but it is worth mentioning that women indicated a willingness to continue their roles as volunteers once the project ended, and many of the reasons are similar to those which show up in larger scale studies of CS programs
    They are leaders in the community and highly respected
    It is their duty to ensure that women who become pregnant after the program ends still have access to this information
    The group meetings provide a strong social environment for women who often feel isolated in their homes
  • Photo—farmers learning how to make a tippy tap

    Surprising responses from farmers—while the project actively tried to integrate ag into the MCGs, it was not as explicit in integrating H&N into the farmers groups. Yet…

    Farmers group members indicated they learned about: handwashing, washing food, how to eat a balanced diet, food groups, proper child care
    Some farmers also mention agricultural information that they received, but all groups included maternal and child health on the list of what they liked best
  • Benefit: MCGs are a proven BCC strategy and can work with the other 2 components of PM2A for sustainable results. MCGs include modules on positive health seeking behaviors, but those will not be practiced if the health system can not meet people’s needs. AND MCGs include nutrition information, and food rations provide an opportunity to begin to practice positive nutrition behaviors immediately, before agricultural changes (due to trainings, improved access to inputs, etc) have had a chance to work.

    Aging out: note issue with MCG manual annex where it notes that PLWs were DISCOURAGED from continuing to participate in Burundi once their children turned 2

    Delinking: RWANU allows women with children up to age 5 to participate in MCGs. From the beginning there are some women who get rations and some who do not
    Social motivators: MCGs are a sustainable model, and that doesn’t change within a PM2A program. Women enjoy participating for many of the same reasons found in CS programs, and it is up to the project to reinforce those, rather than only highlighting the “IF you participate in MCGs, THEN you get rations” idea. Social motivators mentioned in Haiti discussion (respect, sense of duty, social interaction). Also findings from SL: Proven results, respect, approval of husband, opportunity for other groups (VSL, skills training)
    Husbands: SL info, mention dr Ayan’s presentation
    VSLs: SL findings, other organizations (mention FFH?)
  • Care Groups and Integration

    1. 1. Care Groups and Integration ACDI/VOCA Haiti MYAP
    2. 2. • CG groups received a pair of goats and trained on how to raise them • LMs were trained in kitchen gardens and passed this training on to their PLWs • CGs as a basis for VSL group formation • LMs indicate a willingness to continue to hold group meetings and conduct hh visits beyond the end of the project
    3. 3. • Farmers group members in all areas indicated that they learned about health and nutrition through Lead Mother visits to their households • Farmers identified the health and nutrition information to be what they liked best about the project
    4. 4. PM2A and Care Groups
    5. 5. Incorporating MCGs into PM2A Programs PM2A = BCC + Food Aid + Health Systems Strengthening Challenges • Ration conditionality • NW participation once children have reached 2 years of age • Maintaining motivation and participation of LMs once rations have ended Opportunities • Delinking CGs and rations • Social motivators for participation • Incorporating husbands and other community change agents • Using CGs as a foundation for other groups (e.g. gardening, VSLs)
    6. 6. Visit us at @acdivoca