Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Final core group presentation luz


Published on

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Final core group presentation luz

  1. 1. RWANDA EXPANDED IMPACT<br />CHILD SURVIVAL PROGRAM- <br />Integrating CMAM with C-IMCI<br />A Partnership of Concern Worldwide, International Rescue Committee and World Relief<br />CORE group meeting - May, 2011<br />
  2. 2. 1/5 of the total population<br />Over 300,000 children under five years<br />
  3. 3. Direct Beneficiaries of the Program<br />CHW-binome<br />Mother<br />Child<br />Health center Manager /HC providers<br />
  4. 4. Strategic Objective<br />Reduce childhood mortality and morbidity <br />using community-based integrated case management of diarrhoea, pneumonia (ARI), fever (malaria), and nutrition (added later) <br />reinforced by <br />social mobilization and behaviour change strategy (Care Groups)<br />
  5. 5. Level of Effort & Key Interventions <br /><ul><li>ORT
  6. 6. Zinc
  7. 7. Feeding practices
  8. 8. Hygiene practices
  9. 9. Prompt treatment
  10. 10. Bed nets</li></ul>Nutrition<br /><ul><li>OTP for SAM
  11. 11. CBNP – PD/H and Com Kitchens
  12. 12. Small scale HH food security support
  13. 13. Technical Support to MOH
  14. 14. Prompt treatment
  15. 15. Early referral of newborns
  16. 16. Vitamin A , Zinc</li></li></ul><li>Why Integrate Nutrition?<br />Malnutrition is known to be a contributing factor in over 35% of all child deaths in Rwanda<br /> 52% of children are stunted, one in five are underweight, and 4.6% are wasted <br />Access to acute malnutrition services was poor<br />MoH recognized the need to identify and address the management of acute malnutrition in the community<br />
  17. 17. Integration at the program level-Community <br />
  18. 18. Integration at the Program level-Health Facility <br />
  19. 19. Management of Acute Malnutrition flowchart<br />Community <br />Health facility <br />CHW conducts home visit/community growth monitoring and assess child with MUAC<br />SAM (Severe Acute)<br />Moderate (MAM)<br />SAM without complications<br />SAM with complications<br />PD hearth/ Community kitchens<br />Refer to health centre for OTP<br />Referral to district hospital for stabilization<br />
  20. 20. Integration at national level – Advocacy<br /><ul><li>CMAM in national nutrition protocol
  21. 21. RUTF added into routine medical supply chain</li></ul>NATIONAL PROTOCOL FOR THE <br />MANAGEMENT OF <br />MALNUTRITION <br />Kigali, on May,2009<br />REPUBLIC OF RWANDA<br />MINISTRY OF HEALTH<br />P.o. Box 84, Kigali<br /><br />
  22. 22. Impact to Date<br />A number of positive elements emerged from integration of the CMAM approach with Com-IMCI<br />Added value to CSHGP expanded impact<br />National nutrition protocol <br />CMAM services reached and treated over 8,000 Acute Malnourished children <br />Awareness of acute malnutrition (baseline- low in the health agenda) Increased donor funding and available technical support <br />MUAC screening included national vaccination campaigns<br />
  23. 23. Elements & Factors that Facilitated Integration <br />Strong Government commitment - “Emergency Plan to Eradicate Malnutrition” launched in May 2009. <br />Existence of mobilized community network (30,000 non-salaried Community Health Workers)- 2 per village <br />Existence of strong national level technical and policy working groups led by the MOH.<br />Decentralized structure of governance maximized community involvement and mobilization to support integration.<br />
  24. 24. Learning Highlights<br />1. Although CMAM was developed for emergency settings, it has proven to be equally effective in non-emergency<br />3. Network of CHWs integrated into the formal health system and implementing CCM<br />4. CSP strategy provided natural base for CMAM <br />5. No significant improvement in prevalence of acute malnutrition (baseline vs end of project nutrition survey)<br />
  25. 25. What Needs to be Done to Improve Integration<br />Data reporting and integration into national community HIS <br />Collaboration to address the main problems causing malnutrition in the context of integrated approach<br />Design strategies to address barriers to accessing services for malnourished children<br />
  26. 26. Welcome to the Land of Thousand Hills!Thank You<br />