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Understanding the Essential Nutrition Actions Framework_Jennifer Nielsen_5.5.14


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Understanding the Essential Nutrition Actions Framework_Jennifer Nielsen_5.5.14

  1. 1. Case Studies Scale: The ENA Framework Understanding the ENA Framework Pre-session GHPC - May 5th, 2014 Jennifer Nielsen, PhD - HKI Agnes Guyon, MD, MPH - JSI
  2. 2. Health sector The ENA Framework
  3. 3. Mali & Niger – CSHGP • Supported development of national ENA policy statements & training • Collaborated with MOH at regional, district, and health facility levels to improve quality of nutrition content in health services • Community volunteers at village level were linked as extension of health system • Project supervisors reinforced capacity & ownership of local partners • HKI had strong political and technical support from both countries
  4. 4. Mali & Niger – CSHGP • Formative research simple: Mali used Barrier Analysis; Niger used long-time expert • Cascade training with one refresher mid-term: – MTOT 10 days (HKI & MOH at national, region, district) who then trained – Health workers (5 days), who then, with support of MT trained – Community volunteer groups (3 days) • Multichannel SBC emphasized IPC (TIPS) reinforced by group discussions at health centers and community level and radio messages.
  5. 5. USAID bilateral (RBHS) & UNICEF Liberia • Messages developed from formative research & harmonized • Training materials developed based on generic ENA materials • Master trainers carried out cascade training of selected health providers and community volunteers • SBCC strategy finalized • Update IMCI with ENA and CMAM • Integrate ENA into community strategy • Assist the MOHSW in advocacy, the promotion and the roll-out of high impact nutrition interventions through the Essential Nutrition Actions (ENA) framework
  6. 6. LAUNCH project Liberia USAID/Food For Peace Multi-Year Assistance Project – FFP/MYAP by ACDI/VOCA with PCI, JSI & Making Cents • Use MOHSW materials and assist in TOT and roll-out training (HW, CHW, Care Groups) • Carry-out survey post-training on HW practices • Initiate TTM to promote ENA at community level • Draft and use a supportive supervision checklist to mentor HW and organize review meetings with volunteers (GCHV and TTM) • Monitor programs and nutrition practices using mobile phone
  7. 7. Across sectors The ENA Framework
  8. 8. SPRING/Bangladesh 2 sectors :Agriculture & Health 2 Divisions - around 5.7 million  Work with GoB structure, NGOs, Feed the Future partners Essential Nutrition Actions and Essential Hygiene Actions Homestead Food production using the Farmer Field School model and 1000 days  Messages developed from formative research from A&T  Training materials based on ENA generic and HKI-HFP Draft
  9. 9. SPRING/Bangladesh Cascade training  GoB front line health providers trained  GoB Agriculture Extension and community partners  HFP-FFS Facilitators Multi-platformand multi- contact Monitoring & Supervision at all levels Communications Draft
  10. 10. Peace Corps West Africa Food security Partnership Draft 4 sectors :Agriculture/Environment, Education, Health, Small Business  TOT PC staff in March 2013 Benin, Senegal, Guinea, The Gambia & Sierra Leone  French & English  Development & testing of training materials based on ENA generic materials, EHA and HFP  Training roll-out with Peace Corps Volunteers  Monitoring & Supervision
  11. 11. Reference Booklet on key ENA, EHA HFP practices For all PCV regardless of their sectors Community Training guide Orientation guide Health Volunteers Training guide
  12. 12. Nepal and Burkina E-HFP Platform • ENA promoted within in ag-nut strategy (Enhanced Homestead Food Production) • Behavior change through community volunteers (FCHV- Nepal; Grandmothers & Village Health Committees-Burkina) with support of local NGO partners • Village model farms/community gardens were meeting venue for ENA discussions and provided ingredients for enriching complementary foods
  13. 13. Nepal and Burkina HFP Platform • Formative research in Nepal used in-depth interviews, focus group discussions and the DBC framework; in Burkina a community participatory rural appraisal approach • MOH district staff supported training & supervision; MOA & livestock, local development received ENA orientation • BCC also emphasized IPC reinforced by radio & community events • Nepal governance component strengthened multi-sectoral planning and financing at national, regional and VDC levels.
  14. 14. Monitoring The ENA Framework
  15. 15. QUARTERLY MONITORING : • Breastfeeding practices • Mother and child feeding practices/nutrition • Hygiene practices • Food preparation and storage • Time travelled to FDP • Participation in Care Groups & Farmer Groups Liberia-quarterly monitoring surveys are conducted at distribution sites
  16. 16. Use of mobile phone improves transfer of beneficiary information By Paper By Mobile Phone 10.6 13.9 21.4 20.5 10.7 5.9 5.1 3.6 4.1 0 5 10 15 20 25 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 WEEKS
  17. 17. Burkina & Nepal • In Burkina, a round of operations research was conducted with mixed methods: survey, in-depth interviews and observations; weaknesses identified for correction (anemia, home visits) • In Nepal bi-annual surveys and observations were conducted using LQAS to identify areas for strengthening (poultry management)
  18. 18. Thank you!