The document provides an evaluation and recommendations for improving the Community Nutrition Worker (CNW) program at the Ruli District Hospital. It summarizes findings from surveys of CNWs and community members which identified needs like additional CNW training, indoor meeting spaces, and nutrition education materials. The document recommends formalizing CNW training, providing materials and indoor spaces for screenings, including an agronomist to support farming cooperatives and teaching gardens, and better integrating nutrition and HIV programs.
Information flow and_referral_system_project_-_wdi_internship_2012-1Wendy Leonard
As a dual MD-MBA student at University of Michigan, Dan brought a unique perspective to our Sustainable Hospital work. His role was to understand the complex chain of information flowing between clinicians and administrators and between different levels of the Rwandan health care system.
Improving ruli district hospital's patient referral system, final, 4.12.11Wendy_Leonard
Presentation by team of MBA students from Ross School of Business at University of Michigan. Describes recommendations for improving the referral process for rural health centers to the district hospital in rural Rwanda.
Artificial intelligence (AI) is everywhere, promising self-driving cars, medical breakthroughs, and new ways of working. But how do you separate hype from reality? How can your company apply AI to solve real business problems?
Here’s what AI learnings your business should keep in mind for 2017.
Study: The Future of VR, AR and Self-Driving CarsLinkedIn
We asked LinkedIn members worldwide about their levels of interest in the latest wave of technology: whether they’re using wearables, and whether they intend to buy self-driving cars and VR headsets as they become available. We asked them too about their attitudes to technology and to the growing role of Artificial Intelligence (AI) in the devices that they use. The answers were fascinating – and in many cases, surprising.
This SlideShare explores the full results of this study, including detailed market-by-market breakdowns of intention levels for each technology – and how attitudes change with age, location and seniority level. If you’re marketing a tech brand – or planning to use VR and wearables to reach a professional audience – then these are insights you won’t want to miss.
Information flow and_referral_system_project_-_wdi_internship_2012-1Wendy Leonard
As a dual MD-MBA student at University of Michigan, Dan brought a unique perspective to our Sustainable Hospital work. His role was to understand the complex chain of information flowing between clinicians and administrators and between different levels of the Rwandan health care system.
Improving ruli district hospital's patient referral system, final, 4.12.11Wendy_Leonard
Presentation by team of MBA students from Ross School of Business at University of Michigan. Describes recommendations for improving the referral process for rural health centers to the district hospital in rural Rwanda.
Artificial intelligence (AI) is everywhere, promising self-driving cars, medical breakthroughs, and new ways of working. But how do you separate hype from reality? How can your company apply AI to solve real business problems?
Here’s what AI learnings your business should keep in mind for 2017.
Study: The Future of VR, AR and Self-Driving CarsLinkedIn
We asked LinkedIn members worldwide about their levels of interest in the latest wave of technology: whether they’re using wearables, and whether they intend to buy self-driving cars and VR headsets as they become available. We asked them too about their attitudes to technology and to the growing role of Artificial Intelligence (AI) in the devices that they use. The answers were fascinating – and in many cases, surprising.
This SlideShare explores the full results of this study, including detailed market-by-market breakdowns of intention levels for each technology – and how attitudes change with age, location and seniority level. If you’re marketing a tech brand – or planning to use VR and wearables to reach a professional audience – then these are insights you won’t want to miss.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
1. The Ruli District Hospital
Community Nutrition Program:
Evaluation and Recommendations for Improvement
Presented by Sean Morris and Uwacu Theophila
August 3, 2011
2. Project Introduction
1. Evaluation of Community Nutrition Worker program
a. Surveys of CNWs at monthly meetings
b. Observation of village screening activities
c. Interviews with program supervisors
2. Understanding the community nutrition situation
a. Surveys of community members
b. Observation of nutrition education
c. Home visit assessment
3. Project Introduction
3. Health center teaching gardens
a. Nyange HC teaching garden
b. Ruli Sustainable Agriculture Manual
c. Assessment of existing situation
4. Establishment of farming cooperatives
a. Understand existing village associations
b. Identification of potential stakeholders
c. Initiation of Nyange PLWHA pilot farming coop.
4. Project Introduction
Methodology …
• Chose 4 of Ruli’s 7 Health Centers at random
• Used clustered method to select survey participants
• Guidance and No Guidance surveys
• Rwankuba pilot survey
• Community members: Nutrition center, village
screenings, Nyange PLWHA, and VCT mothers
• Many villages and health centers represented
5. Community Situation
Who is represented …
• 8 health centers [2 from other Hospital’s catchment]
• 25 cells
• 44 villages
• 5 males, 62 females
• 73.2% Married; 14.9% Single; 11.9% Widowed
• Educational achievement: 85% Primary; 6% Ordinary
Level; 1.5% Secondary; 4.5% CERAI, Familial, Technical
• Religion: 40.3% Catholic; 16.4% Protestant; 8.9%
Pentecostal; 10.4% Adventist; 24% No religion specified
6. Community Situation
Distance from Home to Health Center
• Combined Average, 1 hr. 38 min.
• Village Screenings, 2 hr. 10 min.
• Nyange PLWHA, 58 min.
• VCT Mothers, 1 hr. 26 min.
• Nutrition Center, 1 hr. 26 min.
7. Community Situation
Distance from Home to Screening Site
• Combined Group Average, 25
min.
• Village Screenings, 16 min.
• Nyange PLWHA, 36 min.
• VCT Mothers, 25 min.
• Nutrition Center, 28 min.
8. Community Situation
Household Circumstances:
• Average size, 5 people (ranging between 3 & 12)
• 85% of total sample have children <5 years
• 70% own land; 18% rent land; 12% live with extended family
• 85% farmers; 11.9% coltan miners; 10% artisans; 7.5% public
institution workers; 4.5% carpenters; 1% unemployed
9. Economic Situation
Estimated Monthly Household Income of • Majority of community
Community Members members have very little
money to spend on food &
health insurance.
• Consistent with observations
0-5000Rwf
of screening participants’,
5001-10000Rwf and home visit situations.
Thought question…
10001-15000Rwf
• What is the best way to
15001Rwf+ combat malnutrition in a
No Response poor population that has
access to limited cultivating
space?
10. No Space for the Poor
Bar Chart Bar Chart
10 If f4.1, how large is the Has your child ever
area of land that you been to the
cultivate? malnutrition center for
Small area 12.5 treatmet?
Medium area Yes
8 Large area No
10.0
6
Count
Count
7.5
4
5.0
2
2.5
0 0.0
0 0<x<5000 5000<x<10000 10000<x<15000 +15000 0 0<x<5000 5000<x<10000 10000<x<15000 +15000
What is your estimated monthly household income? What is your estimated monthly household income?
11. Agriculture Situation
Available Land …
• 15% of CNW villages report a “large area to farm”
• Consistent with community member surveys…
• 58.9% have small area
• 37.5% have medium area
• 3.6% have large area
• 67% of VCT mothers, and 70% of Nutrition Center mothers
report having a “small” area to farm…
12. Agriculture & Malnutrition
Seasonality of Malnutrition Incidence and Cultivating Challenges
60
50
40
% of Respondents
30
Months of Highest Malnutrition Incidence
20 Most Difficult Month to Cultivate
10
0
13. Let’s Work Together!
Opportunities for Farming Cooperative Formation
80
70
60
% of Respondents
50
40 Work Alone
Work Together
30 Both
20
10
0
Total Village Screening Nyange PLWHA VCT Mothers Nutrition Center
Mothers
14. Need for Diversity
Village Level Crop Production
87
68
61 Beans
Maize
37
Tubers
34
Coffee
9 Vegetables
9 Soya
Bananas
5
Fruit
4
Wheat
3 Sorghum
0 10 20 30 40 50 60 70 80 90 100
% of Villages Growing...
15. Community Food
Security Summary
• Average Consumption-to-Sale Ratio = 90:10 (76% at 100:0)
• Vast majority of community members are working alone!
• Overall lack of crop diversity nutrient diversity
• Those who are poor, and at greatest risk of malnutrition have
marginal land access
• Malnutrition is temporal; therefore predictable and beatable!
16. CNW Situation
Who is represented …
• 4 health centers [Ruli, Rwankuba, Muhondo, & Coko]
• 23 cells
• 85 villages
• 44 males, 56 females
• 92% Married; 2% Single; 6% Widowed
• Educational achievement: 75% Primary; 8% Ordinary
Level; 5% Secondary; 12% CERAI, Familial, Technical
• Average CNW age – 38.9 years
• Average tenure as CNW – 6.1 years
17. CNW Situation
Satisfaction …
• Average satisfaction (from 1 to 10) – 8.05
• “How has being a CNW improved your life?”
• 62% report improved diet and nutrition knowledge
• 59% report improved capacity to care for family
• 98% see reduced malnutrition since beginning their work
• 94% report good attendance at each screening
• Only 26% claim to have adequate resources to perform
their duties…
18. Village Screenings
Growth Monitoring
• Weight of each child
under 5 years of age
• Record weight
• Referral based on
growth chart status
• Growth chart also
includes vitamin and
immunization history
19. Village Screenings
Information, Education, Co
mmunication (IEC)
• Convey relevant
nutrition, infectious
disease, or lifestyle
information to the
community
• MOH Guidebooks –
rarely used…
• Sometimes
planned, often
impromptu
20. Village Screenings
Kitchen Demonstration
• Demonstrate
hygienic, balanced meal
preparation
• Explain the importance of
a balanced diet
• Give practical suggestions
for preparing food
specifically for the child
21. CNW Needs
Greatest needs to improve service from CNWs to community …
• Additional training – 81%
• Training is currently informal, on the job training
• Indoor meeting space – 70%
• Most village screenings observed took place outdoors
• Cooking supplies – 42%
• Currently, supplies are often borrowed from community
• Nutrition education materials – 41%
• They should have MOH IEC guidebook in each village
22. CNW Needs
Barriers to providing adequate service to the community …
• Lack of Materials – 46%
• This includes kitchen, education, and record keeping
• Evil ideologies of parents – 41%
• Discouraging screening attendance; belief in traditional
healing; failure to “buy into” nutrition education
• 86% give instruction in agriculture to their village, BUT 99% desire
more sustainable agriculture training opportunities
23. CNW Knowledge
Perceptions of malnutrition …
• Only 15.7% believe that the children of HIV+ mothers are more
susceptible to malnutrition!!!
• BUT … 100% know that nutrition is especially important for HIV+
individuals
• 91% know the number of months that an HIV+ mother should
exclusively breastfeed (6 months)
• ~70% perceive a problem of malnutrition in Rwanda … only
27% see malnutrition as a problem in their own village. Denial?
• Only 26% of CNWs check for all signs of malnutrition [swollen
cheeks/legs, large belly, hair discoloration, signs of anemia]
24. CNW Improvements
Community Member Needs for More Information about Nutrition
Improvement of Nutrition Situation More Training/Education of Parents
Support for Creating Agriculture Coop
Care/Hygiene of Children
Having a Kitchen Garden
More HC Supervision of Child
Increased Food Access for <5 Children
Respect Decisions of Health Leaders
More Access to Land
Family Planning
0 5 10 15 20 25 30 35 40
No Ideas
% of Respondents
25. CNW Improvements
Community Member Suggestions for CHW Program
Better Education and Communication
to Parents
More Home Visits
Increased CHW Training
Take a Greater Stake in Child Growth
No Suggestions
Improved Information About Livestock
0 10 20 30 40 50 60
% of Respondents
26. CNW Situation Summary
• Desire for more training opportunities to better serve village
• Nutrition, Agriculture, Counseling for parents, etc.
• Lack of kitchen materials and indoor meeting space
• Most problematic during the rainy season – this is also the
time of greatest malnutrition (slide 12)
• Need for improved information about HIV and nutrition
• Need encouragement in dealing with parent ideologies, and
reminding that the fight against malnutrition is not over!
27. Recommendations
① Training and Informational Assistance
i. Formal training at program entry
ii. Increase involvement of village husbands
iii. Printed instruction for CHW diagnosis and referral
② Materials and Monthly Screening Improvement
i. Indoor kitchen and supplies for each village
ii. Central, enclosed meeting space for IEC
③ Agriculture and Food Security Assistance
i. Inclusion of agronomist into Ruli Nutrition Program
ii. Working teaching gardens at every health center
iii. Farming cooperative formation – SOSOMA and Food Security
iv. Supervised installation of kitchen gardens by CHWs
④ Integration of Nutrition and HIV Programs
i. Opt-in HIV register for each village
ii. Kitchen demonstrations and nutrition education for HIV+ mothers
28. 1. Training and Information
Objective Responsibility Feasibility Priority
Health Center
Formal Training High High
CHW Leaders
Include Village CHWs, Health
Medium Very High
Husbands in IEC Centers, Hospital
Printed
instruction for The Ihangane
High High
CHW referral Project
protocols
29. 2. Materials and Screening
Objective Responsibility Feasibility Priority
Indoor kitchen The Ihangane
Medium Medium
for each village Project, CHWs
Enclosed
The Ihangane
meeting space Low Medium
Project, CHWs
for IEC
30. 3. Agriculture and
Food Security
Objective Responsibility Feasibility Priority
Objective
Inclusion of Ruli Responsibility Feasibility Priority
The Ihangane Project,
Hospital
Inclusion of Ruli High High
Ruli Hospital
The Ihangane Project,
Agronomist
Hospital High High
Ruli Hospital
Farming Coop.
Agronomist CHWs, Ruli Hospital The
High Very High
Formation
Farming Coop. Ihangane Project
CHWs, Ruli Hospital
High Very High
Working Teaching The Ihangane Project
Formation
Ruli Agronomist, CHWs,
Gardens at Each
Supervised High High
Health Centers
Health Center
Kitchen Garden CHWs, Health Centers Medium Very High
Supervised Kitchen
Installation
CHWs, Health Centers Medium Very High
Garden Installation
34. Sustainable Agriculture
• Raised or Double-Dug beds – Increase land area; deep root
penetration; increased water retention
• Compost Pile Construction – Improve soil fertility; reduce
unnecessary purchase of chemical fertilizer that harms soil
• Inter-planting & Close Spacing – Reduce pest pressure;
improve yields; increased water retention
• Crop Rotation and Planning – Improved soil fertility;
preparation for months of difficult cultivation
“Ruli Hospital Sustainable Agriculture Manual”
36. 4. Integration of Nutrition
and HIV Programs
Objective Responsibility Feasibility Priority
Opt-In HIV Register Ruli Hospital, Health
High High
for Each Village Centers, CHWs
Kitchen Demo.
and Nutrition Ruli Hospital, Nutrition
Education for VCT Center, The High High
mothers at the Ihangane Project
Nutrition Center
37. Thank you! … Questions?
① Training and Informational Assistance
i. Formal training at program entry
ii. Increase involvement of village husbands
iii. Printed instruction for CHW diagnosis and referral
② Materials and Monthly Screening Improvement
i. Indoor kitchen and supplies for each village
ii. Central, enclosed meeting space for IEC
③ Agriculture and Food Security Assistance
i. Inclusion of agronomist into Ruli Nutrition Program
ii. Working teaching gardens at every health center
iii. Farming cooperative formation – SOSOMA and Food Security
iv. Supervised installation of kitchen gardens by CHWs
④ Integration of Nutrition and HIV Programs
i. Opt-in HIV register for each village
ii. Kitchen demonstrations and nutrition education for HIV+ mothers