Maternal Anemia within Child Survival Grants: Lessons Learned at Helen Keller International

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Maternal Anemia within Child Survival Grants: Lessons Learned at Helen Keller International …

Maternal Anemia within Child Survival Grants: Lessons Learned at Helen Keller International

Core Group Spring Meeting Pre-Session, Monday April 26, 2010

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  • The seven actions are promoted by health workers and community workers at six key contact points in the life cycle of women and young children. These contact points include during pregnancy, at delivery, during post-natal and family planning contacts, during immunization contacts, as well as during both well child and sick child contacts. Specific life-cycle appropriate messages are promoted at each contact point opportunity. Thus, for example, exclusive breastfeeding can be promoted during pregnancy, delivery as well as immediately postnatal, and further breastfeeding messages can be given (depending on the age of the child) during immunization, well child as well as sick child contacts.

Transcript

  • 1. Lessons Learned at Helen Keller International Core Group Spring Meeting Pre-Session Monday April 26, 2010
  • 2. Core Group Questions
    • What is the largest barrier that prevents better integration of maternal anemia control interventions within your programs?
    • What change do you feel will make the largest difference in improving the integration of  anemia control interventions?
  • 3. Essential Nutrition Actions (ENA): The Framework for HKI’s Nutrition Programs
  • 4.
    • The ENA approach
    • Focuses on women and under-twos
    • Integrated package of proven preventative actions
    • In 7 areas covering IYCF and micronutrients and women’s nutrition
        • Behavior change communications techniques
    • Objective to “go to scale” to reach over 80% coverage to achieve public health impact
  • 5. 1. Health facility level: integrate ENA actions into existing health contacts at all health services; 2. Community-level: work with community-based organizations & networks from all sectors; and 3. Behavior change: reinforce ENA actions through behavior change communication at all levels, including inter-personal communication, mass media and community mobilization . Three cornerstones of ENA programs
  • 6. 7 Proven Nutrition Actions Integrated control of anemia Complementary Feeding Feeding of sick children Breastfeeding Control of iodine deficiency disorders Control of vitamin A deficiency Women’s nutrition
  • 7. 6. Integrated Control of Anemia
    • D e-worming for pregnant women and children
    • Malaria prevention and control
    • IFA supplementation
    • Promotion of iron-rich foods
    • VAS
    • Fortification of staples
  • 8. DELIVERY/EARLY NEO-NATAL: safe delivery, early BF & EBF, pp vitamin A, iron/folic acid, diet, FP, STI prevention PREGNANCY: TT, antenatal visits, iron/folic acid, de-worming, anti-malarial, diet, EBF, risk signs, FP, STI prevention, safe delivery, iodized salt POSTNATAL AND FAMILY PLANNING : EBF , diet, iron/folic acid, diet, FP, STI prevention, child’s vaccination WELL CHILD AND GM/P: monitor growth, assess and counsel on BF and CF, iodized salt, check and complete vaccination Vitamin A, De-worming SICK CHILD: monitor growth, assess and treat per IMCI, counsel on BF & CF, assess and treat for anemia, check and complete vitamin A Immunization/ de-worming IMMUNIZATION: vaccinations, vitamin A, de-worming, BF, CF, assess and treat infant’s anemia, FP, and STI referral Six critical life cycle contact points
  • 9. Outcomes HKI Mali CSP- Koulikoro Region
  • 10. Mali - Achievements & Challenges
    • Comprehensive training of CSCom staff to improve nutrition services
    • Widespread knowledge of key messages, especially IYCN
    • SIAN reach >80% coverage (deworming PPW)
    • Flour fortification multi-partner consortium (80% production)
    • Supply of free IFA and SP sporadic
    • Sub-optimal attendance at ANC
    • Turnover of trained staff
    • Community BCC needs reinforcement
    • Maternal nutrition received less emphasis
  • 11. Outcomes HKI Niger CSP-Diffa Region Indicators Baseline value Endline value Target Indicator 3 % of pregnant women who took iron/folic acid tablets acid during the last 24 hours 60% 87% 80% Indicator 16 % pregnant women attending IHCs and health posts receiving SP as a component of malaria control package N/A 82 % 100% Indicator 20 % women in the 2nd and 3rd trimester attending IHC and health posts will receive all components of the anemia control package 0 68% 50% Indicator 21 Anemia prevalence among pregnant women in the project area reduced 62% 7% 30%
  • 12. Niger - Achievements & Challenges
    • Comprehensive ENA training at health facilities and communities
    • Saturated communities with key messages
    • CMAM services increased health seeking
    • Women reported high compliance with IFA and knowledge
    • PPVAS
    • IFA supplies inadequate until year 5
    • «Gratuité de soins» (April 2006) undermining stocks of essential medicines
  • 13. Most significant needs
    • Supplies of key inputs (IFA, SP, ITNs)
    • Food security
    • Effective BCC (interpersonal negotiations)
    • Improved family planning (including adolescents)