Presentation_Jurczynska - Catalyzing Investments in RMNCAH at the Community L...
Essential Nutrition Actions_Agnes and Nielson_10.10.12
1. How to translate the nutrition
momentum into countries?
Lessons Learned from
previous program on
implementing the
ENA framework
Jennifer Nielsen HKI
Agnes Guyon SPRING/JSI
Core Group – Fall meeting 2012
2. What is the difference between ENA and
IYCF?
What is the difference between ENA and
Lancet High Impact Nutrition
Interventions?
3. The Essential Nutrition Actions
Nutritional Care
Optimal Complementary
Women’s Nutrition Breastfeeding of the sick &
Feeding with BF
Malnourished child
Control of
Vitamin A deficiency Control of Control of Iodine
Anemia Deficiency Disorders
4. Window of opportunity
1,000 days from conception to two years
nutrition of girls & women
especially pregnant and
lactating
infant & young children,
especially 0-24 months
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10. Great similarity…
Essential Nutrition Actions, The Lancet
and The SUN Framework for Action
Optimal Nutritional Care
Complementary of the sick &
Breastfeeding Feeding with BF
Malnourished child Women’s Nutrition
Control of
Vitamin A deficiency
Control of Control of Iodine
Anemia Deficiency Disorders
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11. Today…
Agreement on the ‘what’
Challenge is now the ‘how’:
operationalizing how to mainstream these 7 ENAs
‘at large scale’ to achieve a public health impact
“The ENA framework”
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12. Countries with ENA* …
Indonesia
India
Cambodia
Bangladesh
Nepal
* Various levels of engagement from ENA at community level only to ENA at national level.
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13. What are the objectives of the ENA
framework?
What is the framework?
14. Consider the huge number of missed
opportunities
Source: World Bank, HNP
15. Operationalize nutrition support at large scale
How do we reduce the ‘missed
opportunities’ to support nutrition in
existing programs?
How do we mainstream into existing
programs both inside and outside the health
sector?
And, how do we roll out the ENA framework
to achieve large scale?
16. ENA framework extends
nutrition coverage within the health sector…
Child Health
Nutrition programs
Newborn health Reproductive Health
From policy to delivery
EPI Lactation Amenorrhea Method
Community IMNCI/CCM with Family Planning
Health facilities IMNCI Maternal Health
CMAM
Infectious Diseases
Control of Malaria
(Insecticide Treated Nets &
Treatment)
Tuberculosis
HIV/AIDS (PMTCT) 16
17. Critical health contacts for infant feeding,
micronutrients & women’s nutrition
PREGNANCY: diet, iodized DELIVERY: Cord clamping,
salt, iron/folic acid, de- Initiation BF, vitamin A,
worming, anti-malarial, iron/folic acid, diet
prep to BF.
POSTNATAL AND FAMILY IMMUNIZATION: BF & CF,
PLANNING: LAM & BF, vitamin A, de-worming,
diet, iron/folic acid, treat assess and treat anemia
anemia
WELL CHILD & GMP
monitor growth, assess and SICK CHILD & SAM/MAM:, counsel on IYCF feeding,
counsel on IYCF, iodized assess and treat for anemia, check and complete 17
salt vitamin A, de-worming,
18. ENA framework extends
nutrition coverage outside the health sector…
Food Production Food Security
From policy to delivery
Pre-Service
Water and Education
Climate Change Sanitation
Women in
Schools Development
Mass Media
19. ENA framework create the buzz
at community level…
Agriculture Education
Community Health
Workers
Savings groups
Local Development
& Planning
20. BCC the backbone for the ENA framework
Promote small do-able actions to demystify nutrition
Harmonization through
various tools
Poopy and Counseling cards
radio/TV
Posters Newsletters
Job aids Health booklet
Formative Research to help over-come family and community obstacles
21. BCC: build on partners what already exists
1. Inter-personal counseling
Health provider with mother
Community worker with mother
Mother-to-mother
Peer counseling
2. Group discussions
Breastfeeding support groups
Savings & credit groups
Homestead food production groups
Listening clubs (cassettes and radio)
3. Informal settings
Market days
Fetching water or wood
4. Mass media
Radio 21
Village theatre groups
22. Ultimate goal: saturate the environment with
nutrition practices
Enroll a large number of volunteers
across sectors
Health
workers
Community volunteers supporting Community
assisting at health mothers volunteer making
clinic home visits
Community volunteers
supporting women at chance
Community health encounters (market, fields,
festivals Agricultural extension collecting firewood)
workers supporting mothers
23. Small Group Work
Each group discuss a case study (20 minutes)
Report back (5 minutes)
Question:
If you were Country Director…
Editor's Notes
We focused our efforts in these countries with the objective of showing behavior change impact at scale. In each country there was a sizeable catchment area population ranging in size from a million to over 6 million people across multiple districts and regions.
We focused our efforts in these countries with the objective of showing behavior change impact at scale. In each country there was a sizeable catchment area population ranging in size from a million to over 6 million people across multiple districts and regions.
We focused our efforts in these countries with the objective of showing behavior change impact at scale. In each country there was a sizeable catchment area population ranging in size from a million to over 6 million people across multiple districts and regions.