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World Relief Nutrition Weeks

World Relief Nutrition Weeks

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Allison Flynn, MPH, Health and Nutrition Program Advisor, World Relief discusses community-based efforts to prevent stunting, primarily World Relief's Nutrition Weeks approach that builds on evidence-based models at the CCIH 2018 Conference.

Allison Flynn, MPH, Health and Nutrition Program Advisor, World Relief discusses community-based efforts to prevent stunting, primarily World Relief's Nutrition Weeks approach that builds on evidence-based models at the CCIH 2018 Conference.

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World Relief Nutrition Weeks

  1. 1. Community Based Stunting Prevention: the Case for Nutrition WeeksALLISON FLYNN, MPH PROGRAM ADVISOR, HEALTH & NUTRITION CCIH ANNUAL CONFERENCE, 2018
  2. 2. Partnership Starts at the Community Rwanda: Standard MOH CBNP brought movement on wasting but not chronic malnutrition ◦12.7% of primary school repetitions are associated with stunting ◦Annual cost of undernutrition: 11.5% of Rwanda’s GDP (CFSVA 2011) ◦Nyamagabe District: 53.5% stunting of children under 5 An issue of child care practices and illness, not just poverty or food security?
  3. 3. Nutrition Weeks Innovation Prevent stunting in the 1,000 Day window ◦ Rooted in Positive Deviance/Hearth model Tested in Tangiraneza “Start Well” Innovation Child Survival Project, 2012-15 Sessions led by Village Nutrition Committees ◦Training cascaded through health system and Integrated Care Groups (which included a religious leader) ◦Significant mobilization and logistical support from community leaders and churches
  4. 4. Nutrition Weeks Innovation 10-15 mothers (pregnant or with a child under 2) gather for a week of intensive, participatory nutrition learning focusing on key behaviors identified through formative research ◦Used diverse local foods to cook together daily and practice active feeding ◦Fathers and Grandmothers invited on specific days Initial community mobilization through community meetings Follow up and reinforcement through household visits by Integrated Care Group members
  5. 5. Piloting the Approach Program implemented from 2012-2015 as part of Tangiraneza “Start Well” Innovation Child Survival Project (USAID) ◦Nutrition Weeks tested in addition to Integrated Care Groups implementing Rwanda Community Based Nutrition Protocol in intervention and comparison areas NWs held 3 times per year in 283 villages (intervention area) 75.6% of mothers in intervention area participated in NWs
  6. 6. Results Nutrition Weeks were successful in improving child diet: a proxy for nutritional status Children exposed to Nutrition Weeks were 23% more likely to achieve Minimum Acceptable Diet
  7. 7. Results: Dietary Diversity & Active Feeding Children in NW area were: ◦30% more likely to reach Minimum Dietary Diversity ◦14% less likely to be actively fed
  8. 8. Results No significant difference noted for Minimum Meal Frequency or Appropriate Introduction of Complementary Foods over standard MOH CBNP implemented through Integrated Care Groups
  9. 9. Lessons Learned
  10. 10. Why it Works Participatory ◦Group Size ◦Lesson Structure Regular Reinforcement ◦3 cycles per year for all moms ◦Follow-up visits from ICG Saturation ◦Social Support: “In It together” ◦Support at all levels of community
  11. 11. Partnership: the Key ◦Health System ◦Community Leaders ◦Churches ◦Fathers ◦Grandmothers ◦Moms
  12. 12. Future Learning and Considerations for scale Applying social capital theory Barriers to dietary diversity Linkages to other areas and sectors Cost Effectiveness of NWs without a Care Group structure
  13. 13. Adaptations in Progress Turkana, 2017 Ethiopia (FH, 2018) Malawi, 2018 Toolkit in development
  14. 14. worldrelief.org

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