Group presentation on "Blended training course" at Developing a nutrition training roadmap to support India’s nutrition progress (17-18 Dec 2019)

1. Blended +
The Academy for Super 600
Dr Rupal Dalal , Aparajita Patra , Thomas Forissier, Devaji

2. From the Kalama Sutta
'Come Kalamas. Do not go upon what has been acquired by repeated
hearing; nor upon tradition; nor upon rumor; nor upon what is in a
scripture; nor upon surmise; nor upon an axiom; nor upon specious
reasoning; nor upon a bias towards a notion that has been pondered
over; nor upon another's seeming ability; nor upon the consideration,
"The monk is our teacher."
Gautama Buddha on the importance of questioning

3. Who are the 5 people in the districts
Group I: District magistrate
Group II – Phase I
• District and Block health officer
• District and Block Program officer ICDS
• District and Block Livelihood mission officer
Group III: Phase II
• District Education officer
• District Agriculture officer

4. What Creates Value
1. Results
2. Appreciation for Efforts& Results
3. Clear Linkage of Results to Career progression [ outcome and
impact level ]…….bring outcomes into focus – we see inputs
changing
4. Recognition of a team [ MP + MLA/s+ Super Six]
5. Empathy driven - Small – Prototypes

5. What Should we prioritise
•Wo-men and the child
• AMIYCN – Thematic
• Interpregnancy period – Intervene before she becomes pregnant
• Pregnancy
• Early initiation of breastfeeding
• Exclusive effective breastfeeding
• Complementary feeding
• Rapid view of management of acute malnutrition and understanding of risk factors
Systems : Health - ICDS – Livelihood mission ( in the first phase )
Actions :
• What works to effectively implement
• Convergent actions
RoI : Returns of impact > Returns on investment
• Adolescents / Agriculture and other systems : Phase II

6. 732 districts
For Group I :
Batch size : 30
Within the state : the Academy moves to the trainee
For Group II
Batch size : NOT more than 20
6 Regions : Gujarat – Bihar – Karnataka – Chattisgarh- Telangana- Himachal
Pradesh
Outside the state : the trainee moves to the Academy
For Group III
The academy – Nutrition sensitive outreach

7. Course objectives
• To understand the scientific principles behind MIYCN : with special
focus on Exclusive breast feeding and complementary feeding
• To apply the techniques of BF and CF in a Skill lab setting
• To understand how to activate the system for MIYCN
• To evaluate the status of EBF and CF in their districts
• To create an action plan for achieving
• EBF to 100 % and
• CF coverage to 80% in the next one year from current levels

8. Online Learning Pre course
• Precedes the Face to face session by 2 months
• Pedagogy
• Andragogy
• Theory : Blooms taxonomy
• Domain: Cognitive , Psychomotor and affective

9. Pre course online : Content
• 6 videos : 2 each on maternal nutrition, BF and CF : 60 min
• Five – 5 min handout
• Why nutrition is important
• Maternal nutrition: Why its important and what needs to be done Steps
• EBF theory : Why its important and what needs to be done
• Complementary feeding : Why its important and what needs to be done
• Basic indicators set pertaining the key focus domain ( NFHS3 filled NFHS 4 to
be filled )
• An empty District profile ( IFPRI)
Total duration is 90 min

10. Pre course undertake 3 activities
• Visit a Village and detect a malnourished child : Ask yourself what
can be done by us to this child : Focus on the Familily
• Observe a post delivery breast feeding counselling session in Labour
ward
• Fill the NFHS4 component and the district fact sheet
• Use constructivism as a pedagogy here
• Use the team based approach
• Be creative

11. Main Course : Same for Group I and II
Delivery : Face to face
Learning environment : Class room setting with demo space . Check for
Skill lab setting s too. 10 BF models . 10 CF preparation sets
Residential

12. Session plan Super 600 Course
Day 1 time
Learning method
Session 1 0900- 0930 introduction Game
Session 2 0930- 1100 The Science of AMIYCN from the patient perspective Lecture followed by facliated discussion
First thousand days
Interventions that work
TEA 1100- 11 15
Session 3 1115-1130
The societal view: Basic definitions, burden, determinants and risk
factors of malnutrition
Session 4 1130 - 1300
Demonstration and practice
2 groups: 1 male dominated on BF, 1 female dominated on CF skill lab . demo
Session 5 1300- 1330 Experience sharing of the practice 5 min each 6 participants
LUNCH 1330 -1430
Session 6 1430 - 1530 Yoganidra Guided relaxation
Session 7 1530- 18:00
Activating the system to deliver nutrition prevention interventions
- Changing the behaviors of FLW and FLS
- The levers: capacity building, supervision, data use, enabling environment (fund
flow)
- The principles of quality improvement: improvements must be decided as low as
possible in the system – your role I to support
Session 8 1800- 1830 Summation of the science and the art

13. Session plan Super 600 Course
Day 2 time
Learning method
Session 1 0900- 1030 Reflection of the Day 1
TEA 1030 - 1100
Session 2 1100- 1200 Fundamentals of measurement in nutrition ( Basic Biostatics , epidemiology )
1200-1300
Discussion on sources of data ( system and non system sources), their quality and
what you can do with poor quality data
LUNCH 1300- 1345
Session 3 1400-1415 Gentle stretching exercise
Session 4 1415- 1500 Open house Discussion on session 2 Facliated discussion
Session 5 1500- 1530 Discussion on the district fact sheet Facilitated discussion
Session 6 1530- 17 30 preparation of an action plan for their district Template is pre provided
Session 7 1730 - 1800 hrs Submission of Action plan

14. How do we leave people enthused
• Group I :
• Provide critical input of action plan within 7 working days
• Provide information on the mentoring team within 10 working days
• Mentoring team touches base with the alpha at one month
• Encourage to porotype – give space for failures
• EFFORTS must be recognised and put on record
• Group II :
• Recognise - Certify them at the academy
• Provide critical input on the action plan within in 3 days
• Provide information on the mentoring team within 7 working days
• Mentoring team touches base with the beta team at 15 days
• Fortnightly follow upon Group I
• Monthly touch base with the Group II

15. Online component Post face to face
• 6 additional videos on skills of BF and CF
• And a questionnaire that can be filled in 15 min .

16. 2DAY
2DAY
3months
Mentoring
Group I : Academy
Monitoring
Group II : the Alphas
VALUES
Trouble shooting bottlenecks
PRAISE

17. In the end ….
We have 3 behaviours to Tackle in MISSION MODE
Hand washing
EBF
CF
Opportunity to CREATE ….. 2000 champs for ONE thousand
days
In ONE year
..Could be much more in much less time …

18. Backup slides

19. • Based on Bloom’s model, originated in 1956, Anderson and Krathwohl (2001) propose the
following
• revised levels of cognition:
• Remembering: Retrieving relevant knowledge from long-term memory
• Understanding: Determining the meaning of instructional messages, including oral, written, and
graphic
• communication
• Applying: Carrying out or using a procedure in a given situation
• Analyzing: Breaking material into its constituent parts and detecting how the parts relate to one
another and to
• an overall structure or purpose
• Evaluation: Making judgments based on criteria and standards
• Creating: Putting elements together to form a novel, coherent whole or make an original product

20. Psychomotor Domain
• The psychomotor domain includes physical movement, coordination, and use of
the motor-skill areas. Development
• of these skills requires practice and is measured in terms of speed, precision,
distance, procedures, or techniques
• in execution. The levels, according to Dave, 1975, include:
• Imitation: Observing and patterning behavior after someone else
• Manipulation: Being able to perform certain actions by following instructions and
practicing
• Precision: Refining, becoming more exact. Few errors are apparent.
• Articulation: Coordinating a series of actions, achieving harmony and internal
consistency
• Naturalization: Having high level performance become natural, without needing
to think much

21. Affective Domain
• Receiving Phenomena: Awareness, willingness to hear, selected attention.
• Responding to Phenomena: Active participation on the part of the learners. Attends and reacts to a particular
• phenomenon. Learning outcomes may emphasize compliance in responding, willingness to respond, or
• satisfaction in responding (motivation).
• Valuing: The worth or value a person attaches to a particular object, phenomenon, or behavior. This ranges from
• simple acceptance to the more complex state of commitment. Valuing is based on the internalization of a
• set of specified values, while clues to these values are expressed in the learner's overt behavior and are often
• identifiable.
• Organization: Organizes values into priorities by contrasting different values, resolving conflicts between them,
• and creating a unique value system. The emphasis is on comparing, relating, and synthesizing values.
• Internalizing values (characterization): Has a value system that controls behavior. The behavior is pervasive,
• consistent, predictable, and most importantly, characteristic of the learner. Instructional objectives are
• concerned with the student's general patterns of adjustment (personal, social, emotional).