The document summarizes the findings of a baseline assessment conducted in Mali's Sikasso region to evaluate anemia prevention and control efforts. Key findings include:
1) Household and client interviews found low levels of knowledge about anemia causes and prevention measures among pregnant women and mothers. Reported usage of best practices like early breastfeeding and bednet use was also low.
2) Community leader and community health worker interviews revealed gaps in knowledge about anemia causes and interventions. Training and support for community health workers was inconsistent.
3) Observation of nutrition outreach activities found opportunities to strengthen counseling and service delivery.
The assessment identifies the need to improve knowledge and uptake of anemia prevention practices at
This document discusses diabetes, kidney disease, and prevention programs in Michigan. It states that around 1 million Michigan adults have diabetes but 1/3 don't know it, and over 900,000 have chronic kidney disease but most don't know. It provides statistics on costs of treatment and discusses several state-funded prevention programs that help people manage diseases through education, lifestyle changes, and care coordination between patients and providers. The programs have shown benefits like reduced hospitalizations, improved health outcomes, and returns on investment.
Health Disparity Among People with Craniofacial Disabilities🌎 Cynthia Ⓥ Murphy ✌
Genetic circumstances typically cause craniofacial conditions, whereas a child is born with physical malformations to the head and body, resulting in the need for lifelong surgical procedures. These disabilities often cause chronic disease, hearing deficiencies, and severe speech impediments. Health disparity is a significant challenge that many face worldwide. This epidemic predominantly affects people with disabilities, including craniofacial conditions. Some of the common craniofacial disorders include Treacher Collins Syndrome, Nager Syndrome, Goldenhar Syndrome, Coffin-Lowry Syndrome, Craniosynostosis, Apert Syndrome, Cleft Lip and Palate, Pfeiffer Syndrome, Facial Infused Lipomatosis, Facial Palsy, among others (Bartzela, T. N., Carels, C., & Maltha, J. C., 2017).
The State of the World's Children 2009 examines critical issues in maternal and newborn health, underscoring the need to establish a comprehensive continuum of care for mothers, newborns and children. The report outlines the latest paradigms in health programming and policies for mothers and newborns, and explores policies, programmes and partnerships aimed at improving maternal and neonatal health. Africa and Asia are a key focus for this report, which complements the previous year's issue on child survival.
The document discusses the evidence for using zinc supplementation in the treatment of childhood diarrhea. Zinc supplementation is now recommended as part of the global diarrhea treatment strategy based on multiple clinical trials showing it reduces diarrhea duration and severity. Zinc addresses diarrhea by maintaining gut integrity and functioning of the immune system. Proper dosage and duration of zinc treatment is important to gain its protective benefits against future diarrhea episodes. Ensuring widespread access to affordable zinc formulations is now a priority in developing countries.
Zinc plays an important role in reducing the severity, duration and recurrence of childhood diarrhea. The World Health Organization and UNICEF recommend all children with acute diarrhea be treated with zinc regardless of the cause of diarrhea. For children under 6 months, 10mg of zinc daily for 10-14 days is recommended, while for children over 6 months up to 5 years, 20mg of zinc daily for 10-14 days is recommended. Zinc supplementation helps stop diarrhea faster and prevents future occurrences by boosting the immune system and aiding in water and electrolyte absorption in the intestines.
Epidemiology of Childhood Malnutrition in India and strategies of controlsourav goswami
This presentation includes the epidemiology of childhood malnutrition in India. the problems and challenges that are being faced in the improvement of the condition and the different strategies for its control.
The document summarizes the annual spring meeting of the Community Health Network. It provides an overview of the meeting agenda focusing on demystifying and using data for community health impact. It discusses progress made towards achieving the Millennium Development Goals and US government commitments to end preventable deaths. It highlights the work of CORE Group including their membership, technical working groups, new tools and resources developed. The summary emphasizes CORE Group's role as a neutral convener that fosters collaboration to address global health issues.
This document outlines a community-based therapeutic care program for severe acute malnutrition (SAM) in Ethiopia's Oromiya region. It describes the high rates of malnutrition, mortality, and fertility in Ethiopia. It then details a three-phase program to address SAM in Arsi Negele, including preparing by recruiting and training community health workers, taking action through home screenings and treating uncomplicated cases, and following up through weekly monitoring. The goal is to effectively treat SAM at the community level through educating mothers and providing ready-to-use therapeutic foods.
This document discusses diabetes, kidney disease, and prevention programs in Michigan. It states that around 1 million Michigan adults have diabetes but 1/3 don't know it, and over 900,000 have chronic kidney disease but most don't know. It provides statistics on costs of treatment and discusses several state-funded prevention programs that help people manage diseases through education, lifestyle changes, and care coordination between patients and providers. The programs have shown benefits like reduced hospitalizations, improved health outcomes, and returns on investment.
Health Disparity Among People with Craniofacial Disabilities🌎 Cynthia Ⓥ Murphy ✌
Genetic circumstances typically cause craniofacial conditions, whereas a child is born with physical malformations to the head and body, resulting in the need for lifelong surgical procedures. These disabilities often cause chronic disease, hearing deficiencies, and severe speech impediments. Health disparity is a significant challenge that many face worldwide. This epidemic predominantly affects people with disabilities, including craniofacial conditions. Some of the common craniofacial disorders include Treacher Collins Syndrome, Nager Syndrome, Goldenhar Syndrome, Coffin-Lowry Syndrome, Craniosynostosis, Apert Syndrome, Cleft Lip and Palate, Pfeiffer Syndrome, Facial Infused Lipomatosis, Facial Palsy, among others (Bartzela, T. N., Carels, C., & Maltha, J. C., 2017).
The State of the World's Children 2009 examines critical issues in maternal and newborn health, underscoring the need to establish a comprehensive continuum of care for mothers, newborns and children. The report outlines the latest paradigms in health programming and policies for mothers and newborns, and explores policies, programmes and partnerships aimed at improving maternal and neonatal health. Africa and Asia are a key focus for this report, which complements the previous year's issue on child survival.
The document discusses the evidence for using zinc supplementation in the treatment of childhood diarrhea. Zinc supplementation is now recommended as part of the global diarrhea treatment strategy based on multiple clinical trials showing it reduces diarrhea duration and severity. Zinc addresses diarrhea by maintaining gut integrity and functioning of the immune system. Proper dosage and duration of zinc treatment is important to gain its protective benefits against future diarrhea episodes. Ensuring widespread access to affordable zinc formulations is now a priority in developing countries.
Zinc plays an important role in reducing the severity, duration and recurrence of childhood diarrhea. The World Health Organization and UNICEF recommend all children with acute diarrhea be treated with zinc regardless of the cause of diarrhea. For children under 6 months, 10mg of zinc daily for 10-14 days is recommended, while for children over 6 months up to 5 years, 20mg of zinc daily for 10-14 days is recommended. Zinc supplementation helps stop diarrhea faster and prevents future occurrences by boosting the immune system and aiding in water and electrolyte absorption in the intestines.
Epidemiology of Childhood Malnutrition in India and strategies of controlsourav goswami
This presentation includes the epidemiology of childhood malnutrition in India. the problems and challenges that are being faced in the improvement of the condition and the different strategies for its control.
The document summarizes the annual spring meeting of the Community Health Network. It provides an overview of the meeting agenda focusing on demystifying and using data for community health impact. It discusses progress made towards achieving the Millennium Development Goals and US government commitments to end preventable deaths. It highlights the work of CORE Group including their membership, technical working groups, new tools and resources developed. The summary emphasizes CORE Group's role as a neutral convener that fosters collaboration to address global health issues.
This document outlines a community-based therapeutic care program for severe acute malnutrition (SAM) in Ethiopia's Oromiya region. It describes the high rates of malnutrition, mortality, and fertility in Ethiopia. It then details a three-phase program to address SAM in Arsi Negele, including preparing by recruiting and training community health workers, taking action through home screenings and treating uncomplicated cases, and following up through weekly monitoring. The goal is to effectively treat SAM at the community level through educating mothers and providing ready-to-use therapeutic foods.
The document discusses various topics related to health including definitions of health, determinants of health, common health issues, health facts and statistics from India, lifestyle factors affecting health, issues faced by different age groups, and the work of organizations to promote health awareness and services. Key statistics include India having the world's largest number of diabetics at 40.9 million, a maternal mortality rate of 250-300 per 100,000 live births, and an infant mortality rate of 49.13 deaths per 1,000 live births. It highlights the roles of non-profits like Sevak Trust and Smile Foundation in providing medical services and education in rural and underserved areas.
The Anemia Mukt Bharat programme (AMB), its implementation, the global burden of anaemia, the aetiology of anaemia, the 2030 Sustainable Development Goals, its successes and shortcomings, the most effective interventions, the reasons the AMB programme was successful in Madhya Pradesh, and its future objectives are all covered in detail in this presentation.
Essential Nutrition Actions_Agnes and Nielson_10.10.12CORE Group
The document discusses implementing the Essential Nutrition Actions (ENA) framework at scale in countries to improve nutrition. It outlines the ENA framework which aims to (1) reduce missed opportunities to support nutrition in existing programs, (2) mainstream nutrition into programs inside and outside health, and (3) roll out ENAs at large scale. The framework utilizes multiple channels like health, food/water, education, and community to promote small nutrition actions through counseling, groups, media and more. The ultimate goal is to saturate the environment with nutrition practices through many volunteers across sectors.
1) A quality improvement project in a remote African village found that improving children's compliance with a malaria treatment plan by concealing the bad taste of medication increased compliance from 48% to 70%.
2) Quality improvement techniques can work in developing countries with limited resources by setting goals, studying processes, testing changes, measuring progress, and building skills in teamwork and measurement.
3) Initiatives like the Integrated Management of Childhood Illnesses program aim to improve health systems in developing countries by measuring quality of services and using that data to identify successful and unsuccessful innovations for improving care.
The document outlines capacity building efforts for diabetes prevention in Jamaica, including determining the extent of diabetes, identifying stakeholders, obtaining initial funding, establishing intermediate goals such as community facilities, surveys, and partnerships with local organizations, and conducting focus groups and pilot studies to fill research gaps around diabetes prevention and treatment. The overall goal is a community-based approach to tackle diabetes through multi-level interventions beyond just the health system.
Chris Auricht - overview of population undernutritionACIAR
This document provides an overview of population undernutrition in eastern and southern Africa. It discusses the elements and consequences of maternal and child undernutrition, including stunting, wasting, underweight, and micronutrient deficiencies. Undernutrition increases the risk of infection, illness, death, and reduced cognitive and physical development. The document also examines indicators and measures of undernutrition, global and regional contexts, and the perspectives on undernutrition in eastern and southern African countries like Ethiopia, Kenya, Malawi, and Tanzania.
Welcome & Overview: State of CORE Group/Board Directions_LeBan_5.10.11CORE Group
This document provides an agenda and summaries for the Community Health Network's annual spring meeting from May 10-13, 2011. The theme of the meeting is "Equity in Health: Ensuring Access, Increasing Use". The meeting will include presentations and discussions on measuring and improving health equity, progress on Millennium Development Goals, strategies to improve coverage equity, and components of community health systems. It outlines the organization's members, initiatives, and resources. The document recognizes those supporting the meeting and looks ahead to upcoming presentations.
Dowa Nutrition Survey Report Final Draft (1).pdfssuserb3b109
This document summarizes the results of a nutrition survey conducted in Dowa District, Malawi from February 17th to 25th, 2004. The survey assessed the nutritional status of children under 5 as well as food security, mortality, morbidity, and immunization. Key findings include:
1) Global acute malnutrition in children under 5 was 2.6% and severe acute malnutrition was 0.7%, showing an improvement from 2003 levels.
2) Stunting affected 61.2% of children and 30.5% were underweight, indicating high levels of chronic malnutrition.
3) The under-5 mortality rate was 0.46 deaths per 10,000 per day, lower than the previous year.
This document discusses the importance of integrating nutrition into development efforts. It summarizes 12 briefs on how good nutrition is essential and linked to achieving goals in various areas like health, education, gender equality, poverty reduction, and the environment. Undernutrition levels in developing countries are high, with over 150 million children affected. Improving nutrition can boost outcomes across sectors like reducing child mortality, bolstering education performance, empowering women, and supporting agricultural productivity. The briefs provide evidence of these impacts and recommendations for interventions to integrate nutrition into related policies and programs.
Lessons in the Integration of CMAM & IMCI Activities_Swedberg_5.12.11CORE Group
This study evaluated the effectiveness of a community-based program for managing severe acute malnutrition (SAM) in Bangladesh. 261 community health workers were trained to screen, assess, and treat children aged 6-36 months with SAM. Preliminary results found high recovery rates and low mortality. Early identification and treatment of SAM and illness likely contributed to the positive outcomes. Coverage was also high due to the decentralized network of health workers and community mobilization around SAM. While facility-based care had low uptake and high default rates, community-based management integrating outpatient and inpatient care was an effective strategy for ensuring treatment of SAM cases.
Addressing Anemia Full Spectrum_Klemm_5.11.11CORE Group
This document summarizes a presentation on addressing anemia given by Rolf Klemm at a Core Group Spring Meeting on May 11, 2011. The presentation covered an overview of anemia, new scientific findings on the impacts of anemia and interventions to reduce it, issues with implementing interventions, and opportunities for integrating anemia prevention into other global health initiatives. It found that while over half of women worldwide are anemic, progress on reducing rates has been limited. Evidence shows maternal iron supplementation can significantly reduce maternal and child mortality and morbidity. However, implementation challenges remain, as many women who attend antenatal care do not receive or take the recommended iron tablets. The presentation calls for greater priority and monitoring of anemia prevention, integrated
The CORE Group 2010 Fall Meeting focused on inspiration, integration, and impact in advancing community health. Key topics included progress on strategic priorities, working group highlights, new members and partners, and recognizing excellence through the Dory Storms Child Survival Award. The meeting emphasized sharing knowledge and experiences to strengthen collaboration and community health approaches globally.
This document summarizes the annual fall meeting of an organization that fosters collaborative action and learning to improve public health practices in low and middle income countries. The meeting was held on October 13-14, 2011 and covered topics like community health workers, malaria case management, nutrition, and maternal and newborn health. It also discussed new members, associates, working groups, staff highlights, and future activities and directions for the organization. Funding for upcoming years is also outlined.
The document discusses the United Nations Millennium Development Goals and focuses on Goal 4 of reducing child mortality. It provides statistics on child mortality rates globally and in Kenya. It then describes an initiative called Goal4 that aims to reduce under-five mortality in the village of Sega, Kenya through establishing a connected community of health practitioners, increasing access to healthcare knowledge and supplies, and implementing programs like an electronic medical record system, connecting community health workers, expanding local health facilities, launching a telemedicine program, and improving public sanitation. The goal is to address the major causes of under-five deaths in the region through an integrated community health approach.
Maternal Anemia within Child Survival Grants Program: Lessons Learned and a ...jehill3
The document reviews maternal anemia programs within the Child Survival Grants Program (CSGP) to identify effective components and barriers. It finds that while programs integrated recommended anemia interventions like iron supplementation and deworming, implementation challenges remained. Outcomes like anemia reduction were achieved in few projects. It recommends CSGP programs improve monitoring of iron tablet receipt and quality of antenatal care to better address maternal anemia.
The document discusses India's national health programs. It outlines the objectives of understanding national health programs and the difference between vertical and integrated programs. It then provides details on various categories of national health programs in India, including programs for communicable diseases, non-communicable diseases, nutrition, and system strengthening. The national health policies guiding these programs are also briefly mentioned.
Livestock-Climate Change CRSP Annual Meeting 2011: Integrating Human Nutritio...Colorado State University
Tips for integrating human nutrition into research on the interaction between livestock/agricultural production and climate change; overview of the Global Livestock CRSP's ENAM project in Ghana. Presentation given by G. Marquis (McGill University) at the Livestock-Climate Change CRSP Annual Meeting, Golden, CO, April 26-27, 2011.
Nurturing connections: advancing gender equality for improved nutrition and l...CGIAR
This presentation was given by Ramona Ridolfi (Hellen Keller International), as part of the Annual Scientific Conference hosted by the University of Canberra and co-sponsored by the University of Canberra, the Australian Centre for International Agricultural Research (ACIAR) and CGIAR Collaborative Platform for Gender Research. The event took place on April 2-4, 2019 in Canberra, Australia.
Read more: https://www.canberra.edu.au/research/faculty-research-centres/aisc/seeds-of-change and https://gender.cgiar.org/annual-conference-2019
Corinna Hawkes
POLICY SEMINAR
Virtual Event - The New Nutrition Reality: Time to Recognize and Tackle the Double Burden of Malnutrition!
DEC 1, 2020 - 09:30 AM TO 11:15 AM EST
Presentation_Behar - Private Public Partnerships and CKDuCORE Group
The document summarizes statistics and information about the sugarcane agribusiness in Mexico, including:
- It produced over 6 million tons of sugar in 2017/2018 and generated nearly 500,000 direct jobs.
- It has a complex supply chain involving sugarcane suppliers, mills, transportation, and the food industry.
- It has a legal framework including laws governing sustainable development of sugarcane and labor relations in mills.
- The government has a National Sugarcane Agribusiness Program to increase productivity and competitiveness.
Presentation_World Vision - Private Public Partnerships and CKDuCORE Group
The Fields of Hope project by World Vision Mexico seeks to prevent and reduce child labor in the sugarcane and coffee sectors in the states of Veracruz and Oaxaca. It aims to benefit 1,520 children at risk of or engaged in child labor across 24 communities and 4 municipalities. The project takes an integral approach through advocacy, collaboration with the private sector, and sensitizing communities and workers, while also promoting access to education.
More Related Content
Similar to Many Actors Tackling Anemia_Hill & Kamgang_5.1.12
The document discusses various topics related to health including definitions of health, determinants of health, common health issues, health facts and statistics from India, lifestyle factors affecting health, issues faced by different age groups, and the work of organizations to promote health awareness and services. Key statistics include India having the world's largest number of diabetics at 40.9 million, a maternal mortality rate of 250-300 per 100,000 live births, and an infant mortality rate of 49.13 deaths per 1,000 live births. It highlights the roles of non-profits like Sevak Trust and Smile Foundation in providing medical services and education in rural and underserved areas.
The Anemia Mukt Bharat programme (AMB), its implementation, the global burden of anaemia, the aetiology of anaemia, the 2030 Sustainable Development Goals, its successes and shortcomings, the most effective interventions, the reasons the AMB programme was successful in Madhya Pradesh, and its future objectives are all covered in detail in this presentation.
Essential Nutrition Actions_Agnes and Nielson_10.10.12CORE Group
The document discusses implementing the Essential Nutrition Actions (ENA) framework at scale in countries to improve nutrition. It outlines the ENA framework which aims to (1) reduce missed opportunities to support nutrition in existing programs, (2) mainstream nutrition into programs inside and outside health, and (3) roll out ENAs at large scale. The framework utilizes multiple channels like health, food/water, education, and community to promote small nutrition actions through counseling, groups, media and more. The ultimate goal is to saturate the environment with nutrition practices through many volunteers across sectors.
1) A quality improvement project in a remote African village found that improving children's compliance with a malaria treatment plan by concealing the bad taste of medication increased compliance from 48% to 70%.
2) Quality improvement techniques can work in developing countries with limited resources by setting goals, studying processes, testing changes, measuring progress, and building skills in teamwork and measurement.
3) Initiatives like the Integrated Management of Childhood Illnesses program aim to improve health systems in developing countries by measuring quality of services and using that data to identify successful and unsuccessful innovations for improving care.
The document outlines capacity building efforts for diabetes prevention in Jamaica, including determining the extent of diabetes, identifying stakeholders, obtaining initial funding, establishing intermediate goals such as community facilities, surveys, and partnerships with local organizations, and conducting focus groups and pilot studies to fill research gaps around diabetes prevention and treatment. The overall goal is a community-based approach to tackle diabetes through multi-level interventions beyond just the health system.
Chris Auricht - overview of population undernutritionACIAR
This document provides an overview of population undernutrition in eastern and southern Africa. It discusses the elements and consequences of maternal and child undernutrition, including stunting, wasting, underweight, and micronutrient deficiencies. Undernutrition increases the risk of infection, illness, death, and reduced cognitive and physical development. The document also examines indicators and measures of undernutrition, global and regional contexts, and the perspectives on undernutrition in eastern and southern African countries like Ethiopia, Kenya, Malawi, and Tanzania.
Welcome & Overview: State of CORE Group/Board Directions_LeBan_5.10.11CORE Group
This document provides an agenda and summaries for the Community Health Network's annual spring meeting from May 10-13, 2011. The theme of the meeting is "Equity in Health: Ensuring Access, Increasing Use". The meeting will include presentations and discussions on measuring and improving health equity, progress on Millennium Development Goals, strategies to improve coverage equity, and components of community health systems. It outlines the organization's members, initiatives, and resources. The document recognizes those supporting the meeting and looks ahead to upcoming presentations.
Dowa Nutrition Survey Report Final Draft (1).pdfssuserb3b109
This document summarizes the results of a nutrition survey conducted in Dowa District, Malawi from February 17th to 25th, 2004. The survey assessed the nutritional status of children under 5 as well as food security, mortality, morbidity, and immunization. Key findings include:
1) Global acute malnutrition in children under 5 was 2.6% and severe acute malnutrition was 0.7%, showing an improvement from 2003 levels.
2) Stunting affected 61.2% of children and 30.5% were underweight, indicating high levels of chronic malnutrition.
3) The under-5 mortality rate was 0.46 deaths per 10,000 per day, lower than the previous year.
This document discusses the importance of integrating nutrition into development efforts. It summarizes 12 briefs on how good nutrition is essential and linked to achieving goals in various areas like health, education, gender equality, poverty reduction, and the environment. Undernutrition levels in developing countries are high, with over 150 million children affected. Improving nutrition can boost outcomes across sectors like reducing child mortality, bolstering education performance, empowering women, and supporting agricultural productivity. The briefs provide evidence of these impacts and recommendations for interventions to integrate nutrition into related policies and programs.
Lessons in the Integration of CMAM & IMCI Activities_Swedberg_5.12.11CORE Group
This study evaluated the effectiveness of a community-based program for managing severe acute malnutrition (SAM) in Bangladesh. 261 community health workers were trained to screen, assess, and treat children aged 6-36 months with SAM. Preliminary results found high recovery rates and low mortality. Early identification and treatment of SAM and illness likely contributed to the positive outcomes. Coverage was also high due to the decentralized network of health workers and community mobilization around SAM. While facility-based care had low uptake and high default rates, community-based management integrating outpatient and inpatient care was an effective strategy for ensuring treatment of SAM cases.
Addressing Anemia Full Spectrum_Klemm_5.11.11CORE Group
This document summarizes a presentation on addressing anemia given by Rolf Klemm at a Core Group Spring Meeting on May 11, 2011. The presentation covered an overview of anemia, new scientific findings on the impacts of anemia and interventions to reduce it, issues with implementing interventions, and opportunities for integrating anemia prevention into other global health initiatives. It found that while over half of women worldwide are anemic, progress on reducing rates has been limited. Evidence shows maternal iron supplementation can significantly reduce maternal and child mortality and morbidity. However, implementation challenges remain, as many women who attend antenatal care do not receive or take the recommended iron tablets. The presentation calls for greater priority and monitoring of anemia prevention, integrated
The CORE Group 2010 Fall Meeting focused on inspiration, integration, and impact in advancing community health. Key topics included progress on strategic priorities, working group highlights, new members and partners, and recognizing excellence through the Dory Storms Child Survival Award. The meeting emphasized sharing knowledge and experiences to strengthen collaboration and community health approaches globally.
This document summarizes the annual fall meeting of an organization that fosters collaborative action and learning to improve public health practices in low and middle income countries. The meeting was held on October 13-14, 2011 and covered topics like community health workers, malaria case management, nutrition, and maternal and newborn health. It also discussed new members, associates, working groups, staff highlights, and future activities and directions for the organization. Funding for upcoming years is also outlined.
The document discusses the United Nations Millennium Development Goals and focuses on Goal 4 of reducing child mortality. It provides statistics on child mortality rates globally and in Kenya. It then describes an initiative called Goal4 that aims to reduce under-five mortality in the village of Sega, Kenya through establishing a connected community of health practitioners, increasing access to healthcare knowledge and supplies, and implementing programs like an electronic medical record system, connecting community health workers, expanding local health facilities, launching a telemedicine program, and improving public sanitation. The goal is to address the major causes of under-five deaths in the region through an integrated community health approach.
Maternal Anemia within Child Survival Grants Program: Lessons Learned and a ...jehill3
The document reviews maternal anemia programs within the Child Survival Grants Program (CSGP) to identify effective components and barriers. It finds that while programs integrated recommended anemia interventions like iron supplementation and deworming, implementation challenges remained. Outcomes like anemia reduction were achieved in few projects. It recommends CSGP programs improve monitoring of iron tablet receipt and quality of antenatal care to better address maternal anemia.
The document discusses India's national health programs. It outlines the objectives of understanding national health programs and the difference between vertical and integrated programs. It then provides details on various categories of national health programs in India, including programs for communicable diseases, non-communicable diseases, nutrition, and system strengthening. The national health policies guiding these programs are also briefly mentioned.
Livestock-Climate Change CRSP Annual Meeting 2011: Integrating Human Nutritio...Colorado State University
Tips for integrating human nutrition into research on the interaction between livestock/agricultural production and climate change; overview of the Global Livestock CRSP's ENAM project in Ghana. Presentation given by G. Marquis (McGill University) at the Livestock-Climate Change CRSP Annual Meeting, Golden, CO, April 26-27, 2011.
Nurturing connections: advancing gender equality for improved nutrition and l...CGIAR
This presentation was given by Ramona Ridolfi (Hellen Keller International), as part of the Annual Scientific Conference hosted by the University of Canberra and co-sponsored by the University of Canberra, the Australian Centre for International Agricultural Research (ACIAR) and CGIAR Collaborative Platform for Gender Research. The event took place on April 2-4, 2019 in Canberra, Australia.
Read more: https://www.canberra.edu.au/research/faculty-research-centres/aisc/seeds-of-change and https://gender.cgiar.org/annual-conference-2019
Corinna Hawkes
POLICY SEMINAR
Virtual Event - The New Nutrition Reality: Time to Recognize and Tackle the Double Burden of Malnutrition!
DEC 1, 2020 - 09:30 AM TO 11:15 AM EST
Similar to Many Actors Tackling Anemia_Hill & Kamgang_5.1.12 (20)
Presentation_Behar - Private Public Partnerships and CKDuCORE Group
The document summarizes statistics and information about the sugarcane agribusiness in Mexico, including:
- It produced over 6 million tons of sugar in 2017/2018 and generated nearly 500,000 direct jobs.
- It has a complex supply chain involving sugarcane suppliers, mills, transportation, and the food industry.
- It has a legal framework including laws governing sustainable development of sugarcane and labor relations in mills.
- The government has a National Sugarcane Agribusiness Program to increase productivity and competitiveness.
Presentation_World Vision - Private Public Partnerships and CKDuCORE Group
The Fields of Hope project by World Vision Mexico seeks to prevent and reduce child labor in the sugarcane and coffee sectors in the states of Veracruz and Oaxaca. It aims to benefit 1,520 children at risk of or engaged in child labor across 24 communities and 4 municipalities. The project takes an integral approach through advocacy, collaboration with the private sector, and sensitizing communities and workers, while also promoting access to education.
Presentation_Wesseling - Private Public Partnerships and CKDuCORE Group
This document discusses the epidemic of chronic kidney disease of unknown etiology (CKDu) affecting agricultural workers along the Pacific coast of Central America. It provides evidence that the disease has an occupational etiology related to heat stress and dehydration experienced by sugarcane and other field workers. Studies show physiological changes in workers consistent with heat stress and dehydration across work shifts. Longitudinal studies find declines in kidney function over harvest seasons among heat-exposed occupations. Intervention studies reducing heat stress through water, rest, and shade have shown reduced declines in kidney function. While some non-occupational factors may also contribute, the evidence strongly suggests that prolonged occupational heat stress is a primary driver of the CKDu epidemic.
Presentation_NCDs - Private Public Partnerships and CKDuCORE Group
Non-communicable diseases like cardiovascular disease, cancer, chronic respiratory disease, and diabetes are leading causes of death and disability globally but receive little focus from global health initiatives. While communicable diseases have declined in recent decades, deaths from non-communicable diseases have increased and pose growing health and economic challenges as treatments remain limited. Experts call for greater prioritization and resources for non-communicable diseases on the global health agenda.
Presentation_HRH2030 - Opportunities to optimize and integrate CHWCORE Group
This document summarizes a conference session on integrating and optimizing community health workers (CHWs) in health systems from global and local perspectives. The session included a fishbowl-style debate where attendees were invited to discuss questions about implementing the WHO CHW Guideline recommendations, important partnerships for training CHWs, priorities for managing and supporting newly recognized CHWs, considerations for optimizing the role of CHWs, and innovations needed to shape and sustain CHWs' roles by 2030.
Presentation_Save the Children - Building Partnerships to Provide Nurturing CareCORE Group
This document discusses the experiences of a mother giving birth to a preemie baby named Becky at 30 weeks gestation. Some key points include:
- Becky spent time in the NICU and the mother felt her discharge was rushed, leaving her unprepared to deal with feeding and breathing issues at home.
- Becky faced various developmental issues over time, including low muscle tone, sensory processing disorder, autism, ADHD, and scoliosis.
- The mother advocates for increased support for preemie babies and their families, including more parent education, counseling, early intervention services, and IEP supports over time.
Presentation_Video - Building Partnerships to provide nurturing careCORE Group
This 4 minute video provides an overview of the key events in the history of the United States from 1492 to the early 2000s. It touches on major milestones like the founding of colonies, the American Revolution, westward expansion, the Civil War, industrialization, both World Wars, the Cold War, and events of the early 21st century. The video presents a high-level chronological summary of major political, economic and social developments that shaped America over the past 500+ years.
Presentation_Perez - Building Partnerships to provide nurturing careCORE Group
This document provides information on empowering health workers and caregivers to deliver therapeutic early childhood development care at home. It discusses how 90% of brain development occurs before age 5 and the importance of nurturing care for young children. The document outlines capacity development for parents and caregivers, including guidance on conducting activities that integrate motor, social-emotional, and therapeutic skills into daily routines. It also stresses the importance of addressing caregiver stress and depression through psychosocial support groups to promote child development.
Presentation_Robb-McCord - Building Partnerships to provide nurturing careCORE Group
The document summarizes key points from a CORE Group meeting on nurturing care for preterm newborns. It discusses how nurturing care involves providing a stable, sensitive environment that meets children's health needs from birth to 3 years. The evidence review examines interventions like skin-to-skin contact, breastfeeding, managing pain and stress, sleep protection and stimulation. Country case studies from both high and low income nations are also being conducted to understand policies and guidelines supporting nurturing care concepts.
Presentation_Discussion - Norms Shifting InterventionsCORE Group
Participants in a small group discussed how to integrate norms-shifting interventions into current projects and programs. They considered what new partnerships would be needed when working to shift social norms and what evidence of the effectiveness of norms-shifting interventions should be collected, for whom, and how.
Presentation_Krieger - Norms Shifting InterventionsCORE Group
The document discusses the origins and theories of social norms. It notes that early theorists like Durkheim, Weber, and Ogburn contributed to understanding where norms come from and how they guide behavior. Parsons further explored how members of society are socialized to norms. Later, feminist anthropologists studied norms and social control, especially regarding gender. The document contrasts philosophical, psychological, and anthropological approaches to studying norms and culture. It argues that knowledge of cultural norms can help reduce unexpected outcomes in social science and shift narratives to achieve behavior change. The example of the Albania Family Planning Project shows how understanding local norms was key to successfully promoting contraceptive use.
Presentation_NSI - Norms Shifting InterventionsCORE Group
This document discusses the key attributes of norms-shifting interventions. It identifies several attributes that make an intervention effective at shifting social norms, including seeking community-level change, engaging people at multiple levels, correcting misperceptions around harmful behaviors, confronting power imbalances related to gender, creating safe spaces for critical reflection, rooting the issue within community values, accurately assessing norms, using organized diffusion, and creating positive new norms. The document provides examples and explanations for each of these attributes.
Presentation_Igras - Norms Shifting InterventionsCORE Group
This document discusses using theory to inform the work of a learning collaborative (LC) on norms-shifting interventions for adolescent reproductive health. It outlines several relevant theories, including social norm and behavior change theory and communication and behavior change theories. It also discusses the value of "bottom-up" program change theory developed from implementation experience. The LC aims to facilitate collaboration between organizations, build knowledge, and develop shared tools to guide effective social norm measurement and practice at scale. By working collaboratively, the LC can take a more experimental approach in this nascent field while still being informed by relevant theories.
Presentation_Petraglia - Norms Shifting InterventionsCORE Group
This document discusses a constructivist perspective on norms and normative change. Some key points of constructivism are that knowledge is constructed through social interaction and prior experiences, and meaning is negotiated through language. Constructivism acknowledges that individuals belong to multiple reference groups and can choose which norms to follow in a given situation. Normative change interventions cannot directly manage or control norms, but may be able to influence them by facilitating dialogue, clarifying language, and encouraging ethical persuasion rather than direct attribution. Norms and beliefs are also difficult to accurately measure.
Presentation_Sprinkel - Norms Shifting InterventionsCORE Group
This presentation provides an overview of CARE's Tipping Point initiative which aims to address child, early and forced marriage in Nepal and Bangladesh through community programming and evidence generation. In Phase 1 from 2013-2017, the project worked with adolescents, parents and leaders in 16 districts across the two countries. Norms influencing child marriage include excluding girls' voices, controlling girls' sexuality, and perceptions of risks/benefits of marriage timing. Phase 2 implements a randomized control trial to generate evidence on effective gender transformative programming and the value of social norms approaches. Challenges included discussing sexuality while successes included girls gaining greater freedom and mobility.
Presentation_Tura - Norms Shifting InterventionsCORE Group
This document discusses the Care Group approach used in an intervention in Nepal from 2005-2010. It aimed to shift social norms around maternal and child health issues through community groups. Formative research identified key norms and barriers. Community groups engaged women to reflect critically and root issues in community values. Evaluations found sustained impact on behaviors like breastfeeding years later. Challenges included focusing directly on norm drivers and unrealistic community health worker workloads. Further research on accurate norm assessment and evidence-based norm-shifting is still needed.
Presentation_Sacher - Norms Shifting InterventionsCORE Group
This document summarizes Cristina Bicchieri's theory of social norms, which is grounded in philosophy, game theory, and psychology. The key aspects of the theory include conditional preferences that depend on social expectations, personal normative beliefs about what should be done, and expectations about what others in one's reference network do and think should be done. The implications for practice highlighted in the document include providing a theory of change, identifying the nature of norms to design appropriate interventions, and using data and illustrative vignettes to measure norms and guide social change programs.
Innovative Financing Mechanisms and Effective Management of Risk for Partners...CORE Group
The document summarizes the Utkrisht Development Impact Bond in India, which aims to improve quality of care in private maternity facilities. It discusses how impact bonds can mobilize private capital for development by lowering investment risk. The Utkrisht bond provides funds for accrediting 360-440 private facilities over 3 years. Facilities receive quality improvement support and investors are repaid based on the number of facilities accredited. Early lessons show facilities are motivated to improve if it grows their business and they receive support meeting standards. The bond also provides a framework for continuously improving the project and managing risks between partners.
Presentation_Multisectoral Partnerships and Innovations for Early Childhood D...CORE Group
This document summarizes a discussion on multi-sectoral partnerships and innovation for early childhood development. It was presented by several experts, including Dr. Maureen Black from RTI International, Dr. Joy Noel Baumgartner from Duke University, Mohammed Ali from Catholic Relief Services, Dr. Chessa Lutter from RTI International, and Dr. Erin Milner from USAID. The discussion covered topics like the importance of early childhood development, the Nurturing Care Framework, metrics and measures for childhood development, partnerships for early childhood programs, and challenges and next steps.
Presentation_Jurczynska - Catalyzing Investments in RMNCAH at the Community L...CORE Group
The document describes an evidence-based advocacy model called the Family Planning – Sustainable Development Goals (FP-SDGs) model. The model allows users to quantify the impacts of different family planning scenarios on 13 Sustainable Development Goal indicators out to 2030 or 2050. Users input baseline data and create three future scenarios capturing various levels of ambition for family planning and other socioeconomic factors. The model then projects population figures and calculates outcomes for the SDG indicators. Results can support advocacy efforts to increase funding and prioritization of family planning programs and policies. Examples of the model's use in Malawi, Tanzania, and West Africa demonstrate its ability to quantify potential development impacts of expanding access to voluntary family planning.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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.
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.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
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.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
1. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Many Actors One Goal:
Actors,
Tackling Anemia in Mothers & Children
A Country Case Study: Mali
Kathleen Hill & Evelyn Kamgang
USAID Health Care Improvement Project
University Research Co., LLC
CORE Spring Meeting May 1st, 2012
1
Session Outline
I. Presentation: Mali Case Study
• HCI Mali anemia project objectives
• Anemia prevalence & causes in Mali (women & children)
• Anemia control best practices: what, when & where?
• Findings from a baseline assessment in Mali’s Sikasso region
2. Group work: Moving to Implementation
• Many actors, One goal: achieving inter-sectorial implementation
in a complex environment
• Models to support implementation planning: CFIR; Program
Assessment Guide (PAG); Breakthrough Series Improvement
Collaborative
3. Plenary Discussion: Putting it all together
2 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 1
2. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Acknowledgements
• USAID Mali Mission (funding & technical support)
• USAID Washington Staff (Nutrition, Malaria, MNCH)
• Consultant: Dr. Halimatou Alaofe
• HCI Project staff in Mali & Niger: Dr. Maina Boucar, Dr.
Karim Sangare, M S b Djib i
K i S Mr. Sabou Djibrina, D Z k i S l
Dr. Zakari Saley
3 USAID HEALTH CARE IMPROVEMENT PROJECT
HCI Mali Anemia Project Goal and Objectives
Program Goal: To reduce anemia prevalence in pregnant
women, mothers and young children in Mali’s Sikasso
region (one district)
Program Objectives:
1. To improve household and community uptake of anemia
prevention/control best practices for pregnant women,
mothers and young children
2.
2 To achieve broad coverage and quality of high impact MOH
anemia prevention/control interventions for mothers and
children within essential lifecycle windows of opportunity
(pregnancyearly post-partuminfancyearly childhood)
4 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 2
3. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Mali Context
Total population: 14.2 million (Feed the
Future)
73% of population rural; 64% li on < 1
f l ti l live
USD per day
ANC rate: 72% (one visit); 63% (2 or
more visits)
Skilled birth attendance rate: 49%
(UNICEF 2010)
Infant mortality rate: 131 per 1000
(UNICEF 2010) Sikasso region: 2nd most
Under 5 mortality rate: 178 per 1000 live populous & poorest region;
births (WHO/UNICEF 2010) most agriculturally productive;
highest stunting rate; Feed the
Moderate-severe underweight < 5 years: Future priority region
About 27% (UNICEF)
Moderate to severe stunting < 5 years:
about 38% (UNICEF)
USAID HEALTH CARE IMPROVEMENT PROJECT
6 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 3
4. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Main Direct & Indirect Causes of Anemia
for Women & Children in Mali
Direct Causes:
Micronutrient Deficiency: primarily iron deficiency; also
vitamin A & zinc (decreased production red blood cells)
Malaria: hemolytic anemia (destruction red blood cells)
Other parasitic infections: mainly schistosomiasis &
hookworm (excessive loss red blood cells)
Indirect Causes:
Lack of childbirth spacing
Food insecurity, malnutrition, poverty
Poor sanitation & access to potable water
Weak access to health services
Early childhood feeding practices (e.g., delayed breastfeeding)
7 USAID HEALTH CARE IMPROVEMENT PROJECT
How Big is the Problem?
Anemia & Related Prevalence Rates in Mali
Other
Anemia
Iron- Malaria parasite
Prevalence
deficiency prevalence prevalence
(Any & severe) anemia (Schisto.)
(S hi t )
76% 73% 23% Schisto.
Pregnant (FAO 2010) (Aguayo, 48% 8% Hookworm
women 2005) (Ayoya 2006)
85% (Mali)
Children 91% (Sikasso) ?? 38% Mali 51% Schisto.
6-59 mos 26% severe (Mali)
mos. (Dabo 2011)
35% severe 59% Sikasso
(Sikasso)
39% 12-17 months (EA&P 2010)
(EA&P2010)
USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 4
5. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Critical Lifecycle Windows for
Uptake and Delivery of Anemia Best Practices
for Mothers & Young Children
Early Post- Infancy Early
partum Childhood
Pregnancy (0-6
(Mother & (6 mos-5
Newborn) months)
years)
Focused ANC Early & exclusive EEBF Complementary feeding
breastfeeding from 6 months
Iron/folate (EEBF)
suppl. Diversified feeding
Micronutrient Vit A suppl.
Deficiency Nutrition best Active feeding sick
practices Iron suppl. mother child
Nutrition best Vit A suppl (2x/year);
practices (mother) Zinc for diarrhea
IPTp x 2 (SP) LLITN use (mother LLITN use (mother LLITN use (mother &
Malaria & newborn) & infant) newborn)
Long-lasting
insecticide-trtd Prompt care Prompt care seeking
bednet (LLITN) seeking fever fever
use
Accessible/quality Accessible/quality care
care febrile illness febrile illness
Hygiene Food & personal Food & personal Food & personal
Parasitic
9 hygiene USAID HEALTH CARE IMPROVEMENT PROJECT
hygiene hygiene
Infections Systematic de-
Main Delivery Venues for
MOH Anemia Control Best Practices
• Community- and home-based: antenatal, early post-
partum & early childhood services via community health
workers (“Agents de Sante Communautaire” ASC) and
( Agents Communautaire”,
community-based health volunteers (“Relais
Communautaire” , RC)
• Facility-based antenatal & early post-partum
consultations: community health centers (CSCOM) &
district referral health centers (CSRef)
• Facility-based well-child and sick-child consultations
(CSCOM & CSRef)
• Quarterly regional MOH-sponsored “Week of Intensive
Nutrition Actions” (SIAN)
10 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 5
6. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Current Status of Selected Anemia Control
Best Practices in Mali
• Breastfeeding within 1st hour of birth: 46% (DHS)
• Exclusive BF until 6 months: 38% (DHS)
( )
• Complementary feeding from 6 to 11 months (fruits,
vegetables, meat): 11-12% (DHS)
• Bednet use previous night: 75-80% (children 0-4 yrs;
however < 10% used pre-treated net)
• Intermittent Preventive Therapy for Malaria in Pregnancy
(IPTp): 2 SP doses in pregnancy: 4% (DHS 2006)
• Care-seeking w/in 24hr onset of fever in children: 23%
• Treatment of febrile illness with ACT: 7.8%
Sources: EA&P Survey, 2010; DHS 2006
11 USAID HEALTH CARE IMPROVEMENT PROJECT
Preparing for Implementation :
Baseline Evaluation in Mali’s Sikasso Region
Baseline Assessment Objectives:
1. Assess anemia-related knowledge, attitudes & practices
among beneficiaries & providers
2. Assess implementation of community- and home-based
anemia control interventions
3. Assess implementation of high-impact MOH Health
Center-based
Center based anemia control interventions including
interventions,
cross cutting health system service delivery supports
12 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 6
7. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
13 USAID HEALTH CARE IMPROVEMENT PROJECT
Data Collection Sites:
12 Communes (household/ community) & 15 Health Centers
in Kadialo & Bougouni Districts (Sikasso Region)
District 15 Health Centers 12 Communes
(CSCOM & CSRef)
1 CSCOM Urban Kadiolo
Kadiolo
K di l 1 CSR f
CSRef
Missenu
3 CSCOM Rural Nimbougou
Dyou
3 CSCOM Urban Bougouni
1 CSRef
Bougouni Koumantou
Bladié
6 CSCOM Rural Banimonotié
Bladiè Tièmala
Koumantou
Koumantou
Défina
14 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 7
8. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Data Sources & Sample Sizes
Community Interviews (12 communes) :
• Community leaders (n=42)
• C
CHW ( C/ SC) (
(RC/ASC) (n=30; 75% RC)
% C)
• Household (pregnant women & mothers) (n=480)
• Observation of 1 SIAN
Health Center (15 centers)
• Interviews managers (n=12) & providers (n=30)
• Client exit interviews: antenatal, sick & well child
consultations (total n=459 )
• Chart audit (n=550)
• Inventory of inputs & service organization (n=12)
15 USAID HEALTH CARE IMPROVEMENT PROJECT
Selected Results
• Household
• Community
• SIAN (Week of Intensive Nutritional Activities)
• Facility
16 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 8
9. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
17 USAID HEALTH CARE IMPROVEMENT PROJECT
Household & Client Exit Interviews: % Pregnant Women
Who Correctly Identified 3 Main Causes of Anemia
(n=688; n=359 household interviews; n=329 client exit interviews)
18 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 9
10. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Household & Client Exit Interviews: % Pregnant Women
Who Correctly Identified Anemia Prevention Measures
(n=688)
19 USAID HEALTH CARE IMPROVEMENT PROJECT
20 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 10
11. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Household & Client Exit Interview Results: % Pregnant
Women Who Reported Selected Anemia Control Best
Practices (n=688)
21 USAID HEALTH CARE IMPROVEMENT PROJECT
Household Interviews: % Mothers of Young Children by
District Who Correctly Identified Pregnancy & Childhood
Anemia Control Best Practices
(n=251; n=121 household; n=130 client exit interviews)
22 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 11
12. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Household & Client Exit Interviews: % Mothers and Pregnant
Women Who Report Specific Health Information Sources
(n=688 pregnant women; n=251 mothers)
23 USAID HEALTH CARE IMPROVEMENT PROJECT
Community Results
• Community Leader Interviews
• Community Health Worker Interviews
CHW Cadres in Mali:
• Agent de Sante Communautaire (ASC): Trained paid
CHW; provides health promotion, prevention & treatment
services; covers 1-3 villages (1,500 persons); helps
supervise RCs
• Relais Communautaire (RC): voluntary CHW recruited by
community; health promotion and prevention; 1 RC per
village (approx. 50 households; 300 persons)
• Traditional Birth Attendent (TBA)
24 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 12
13. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Community Leader Interviews: % Community
Leaders Who Correctly Identified Anemia Causes
by District (n=42)
25 USAID HEALTH CARE IMPROVEMENT PROJECT
Community Leader Interviews: % Community Leaders
Report Recruiting ASC/RCs and Their Perceptions of Key
Services Provided by ASC/RCs (n=42 community leaders)
Leaders who report participating in ASC/RC recruitment: 67%
Community Leader reported Perception of Main Activities for
Leader-reported
ASC/RC:
– General health education: 60%
– Participation in SIAN: 62%
– Mosquito-net distribution: 52%
– Home or community-based ANC: 26%
y
– Home or Community-based PNC (post-natal Care):
21%
26 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 13
14. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
ASC/RC Interviews: % ASC/RC Who Correctly Identify
Anemia Causes (n=30)
27 USAID HEALTH CARE IMPROVEMENT PROJECT
% ASC/RCs in Urban vs. Rural Communes Who Correctly
Identify High-impact Anemia Control Interventions in
Pregnancy (n=20 rural; n=10 urban)
28 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 14
15. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
% ASC/RCs Who Correctly Identify Anemia Control
Interventions for Infants & Young Children (n=30)
29 USAID HEALTH CARE IMPROVEMENT PROJECT
ASC/RC Interviews: % ASC/RCs Who Report Prior
Training in Specific Technical Areas (n=30)
30 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 15
16. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
ASC/RC Interviews: % ASC/RCs Who Report to Routinely
Provide Specific Services as Part of Their Regular Work (n=30)
31 USAID HEALTH CARE IMPROVEMENT PROJECT
% ASC/RCs Who Report Specific Timing of Home-
based Post-natal Care Visits (# days after birth)
(n=30)
32 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 16
17. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Week of Intensive Nutritional Activities (SIAN):
Key Findings by Direct Observation & Interviews
Data Collector Observation:
• Vitamin A & Albendazole (antiparasite) distribution occurs
via 3 primary avenues: Health Center (CSCOM), Village
Chief, mobile team (e.g., mosque or marketplace)
• Vitamin A distribution is much stronger than nutritional
education or anti-parasite treatment
• Nutritional Counseling activities were rarely observed as
p
part of SIAN activities
CSCOM Manager Self-reported Participation:
• 67% Kadiolo
• 29% Bougouni
33 USAID HEALTH CARE IMPROVEMENT PROJECT
% ASC/RC Who Report Participation in Specific
SIAN Activities (n=30)
34 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 17
18. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Selected Health Center Results
• Manager & Provider Interviews
• Chart Reviews
• Client-reported high-impact interventions received during
antenatal, well-child, and sick-child consultations (client
exit and household interviews)
35 USAID HEALTH CARE IMPROVEMENT PROJECT
36 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 18
19. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Provider Knowledge: % Skilled Maternal & Pediatric
Providers Who Correctly Identify Anemia Symptoms
& Causes (multiple choice question)
Pediatric Providers Maternal Providers
(n=5) (n=8)
Nurses, doctors Midwives, nurses,
doctors
d t
Anemia Symptoms:
Fatigue 20% (1) 50% (4)
Pale conjunctivae/skin 100 % (5) 100% (8)
(e.g., palms)
Shortness of Breath 60 % (3) 63% (5)
Anemia Causes:
Iron deficiency 20% (1) 63% (8)
Malaria 100% (5) 75% (6)
Parasite Infections 0% 25% (2)
(diarrhea/intestinal)
37 USAID HEALTH CARE IMPROVEMENT PROJECT
Maternal Provider Knowledge of Anemia Best Practices in
Pregnancy: % Providers Who Correctly Identify High-
impact Anemia Control Practices in Pregnancy
(n=8 providers)
38 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 19
20. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Pediatric Provider Knowledge of Anemia Best Practices for
Infants/Children: % Providers Who Correctly Identify High-
impact Anemia Control Practices for Children (n=8 providers)
39 USAID HEALTH CARE IMPROVEMENT PROJECT
Availability Essential Anemia Control Inputs:
Laboratory, Micro-nutrient Supplements, Anti-malarial &
Anti-parasite Medications: % Facilities with Input (n=12)
% Facilities with
Essential Anemia Control Input
Input
Hematocrit Laboratory Testing 13%
Vitamine A 80%
Iron/Folic Acid (IFA) 100 %
Zinc 80%
Albendazole (de-worming medication) 87%
Sulphadoxine/Pyrimethamine (SP) for IPTp 80 %
Malaria Diagnosis & Medication
Quinine 400mg & 200 mg (Injectible) 100%
Quinine 300mg (oral) 73 %
ACT 100 %
Rapid Diagnostic Test (RDT) 100 %
40 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 20
21. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
ANC Chart Review Findings: % Antenatal Charts with
Anemia Control Best Practices Recorded
(n=300 Charts)
Anemia Best Practice Total
(n=300 dossiers)
Clinical Evaluation
Pregnant client questioned regarding +/- bleeding 2% (7)
Anemia symptom investigated (any) 32 % (95)
Laboratory Examination
Hemoglobin or Hematocrit recorded in chart (ever) 3% (8)
Malaria test noted ever (thick smear, RDT or other) 3% (8)
Anemia Prevention Interventions in Pregnancy
(per MOH policy )
SP prescription noted ever (IPTp) 83% (250)
Iron/Folic Acid prescription noted (ever) 87 %(261)
Deworming with Albendazole 7 %(20)
Distribution of insecticide-treated mosquito net 25% (75)
41 USAID HEALTH CARE IMPROVEMENT PROJECT
42 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 21
22. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Clients Reporting Clinic ANC Anemia Control Best
Practices (n=329 ANC client exit interviews)
ANC Practice Reported by Client % Clients Who
Report Activity
Laboratory Testing
Hemoglobin level 12%
HIV test 3%
No laboratory Testing 84%
Nutritional Counseling 10%
Iron/Folic Acid Prescription/Distribution 98%
Malaria & Hookworm Best Practices
Deworming ((Albendazole) ) 8%
Bednet Counseling 30%
SP for Malaria prevention 54%
Follow-up Visit (when) 71%
43 USAID HEALTH CARE IMPROVEMENT PROJECT
ANC Chart Review Findings: % Antenatal Care
Charts/Patient Cards with Counseling Best Practices
Recorded (n=300)
44 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 22
23. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Health Center Manager Interviews: % Managers Who
Report Regular Counseling/Education Activities
(n=12 managers)
Education Session Type Total Kadiolo Bougouni
(n=14) (n=4) (n=10)
Antenatal Care Consultations
(ANC) 14% (2) 0% 20% (2)
Individual Counseling only 50% (7) 25 %(1) 60 %(6)
Group Counseling only 36% (5) 75 %(3) 20% (2)
Individual & Group Counseling
Well-child Consultations (SPE)
Individual Counseling alone 7 %(1) 25 %(1) 0
Group Counseling alone 29% (4) 0 40% (4)
Individual & Group Counseling 50% (7) 75% (3) 40% (4)
No education/counseling g 14% (2)
( ) 0 20% (2)
( )
Sick-child Consultations
Individual Counseling 50% (7) 50 %(2) 50% (5)
Group Counseling 0 0 0
Individual & Group Counseling 29 %(4) 25% (1) 30% (3)
No education/counseling 21% (3) 25% (1) 20% (2)
45 USAID HEALTH CARE IMPROVEMENT PROJECT
46 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 23
24. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Anemia Best Practices Received during Post-partum & Early Infancy
Clinic Visits As Reported by Mothers of Infants < 7 months (Recent or
Current) (n=66; 34 client exit & 32 household interviews)
Anemia Best Practice Reported by Mothers As % Mothers
Recieved During Post-partum & Routine Infancy Clinic Visits Reporting Best
Practice
FAF prescription (for lactating mother) 39%
Vit. A for mother post-partum 42%
Nutrition Counseling Reported by Client
Exclusive breastfeeding 39%
Nutritional best practices lactating mother 27%
Nutritional best practices infant (0-6 mos) 33%
Iron-rich foods 3%
Vitamin A –rich foods 3%
Vitamin A supplementation needs for infant 17%
Malaria & Hookworm Prevention Counseling Reported by
Clients 21%
Regular de-worming Infancy 3%
Use of insectide-treated nets
Danger Signs & Follow-up Counseling Reported by Clients 2%
Follow-up for infant (when & where) 17%
Newborn/infant danger signs
47 USAID HEALTH CARE IMPROVEMENT PROJECT
Well-child Visit Chart Review Findings: % SPE Charts (or
Patient Carnets) with Recorded Anemia or Anemia-related
Best Practice (n=100 charts; children 0-2 years)
Anemia Control Best Practice Average 2 Bougouni Kadiolo
Recorded During Routine Care Districts n=60 charts n=40 charts
n=100 charts
Growth Monitoring & Acute Malnutrition
Weight recorded 40 % 50 % 25 %
Height recorded 40 % 50 % 25 %
Weight/height % recorded 23 % 22% 25%
Mid upper arm circumference 20 % 17 % 25 %
Clinical examination for 0% 0% 0%
anemia
Vit. A Supplementation 17% 0% 43%
Child feeding status assessed 30% 17 % 43 %
(e.g., BF/not BF)
Any feeding problems noted 0% 0% 0%
Bednet counseling noted 20 % 0% 50 %
Deworming recorded 10 % 0% 25 %
48 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 24
25. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Well-child Chart Review Counseling Results: % Well-child
Chart Visits (or Patient Cards) with Counseling Best
Practices Recorded (n=100 charts; children 0-2 years)
49 USAID HEALTH CARE IMPROVEMENT PROJECT
Sick-child Chart Review Findings: % Sick-child Chart (or
Patient Carnet) Visits with Recorded Anemia or Anemia-
related Best Practice (n=100 charts; children 0-2 years)
Anemia Best Practices % Charts Best Practice
General Evaluation
Weight recorded 9% (13)
Fever/temperature recorded 23% (34)
Anemia Evaluation & Diagnosis/Iron Suppl.
Anemia symptoms recorded (+ or -) 3 % (4)
Hemoglobin or hematocrit recorded (laboratory) 1% (2)
Anemia diagnosis recorded 4% (6)
Iron supplement prescribed 3% (5)
Vitamin A supplement last 12 months 16% (24)
De-worming last 12 months 18% (27)
Malaria Evaluation & Diagnosis
Thick smear or RDT recorded 59% (88)
Malaria treatment 49% (73)
Zinc if diarrhea 5% (7)
50 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 25
26. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Anemia Counseling Best Practices during Well-child
Visits (7 mos-2 years): % Mothers Who Report Best
Practice (n=33 Client Exit Interviews Mothers)
51 USAID HEALTH CARE IMPROVEMENT PROJECT
Conclusions
Selected Challenges:
• Many anemia knowledge & practice gaps (beneficiaries; skilled and
unskilled providers)
• Many coverage gaps i d li
M in delivery of hi h i
f high-impact anemia control i t
t i t l interventions
ti
during critical lifecycle windows at community, household & health center
levels
• Many missed opportunities to deliver best practices (e.g., weak
counseling/BCC in established services; poor timing of post-partum visits)
• Differences between Kadiolo & Bougouni Districts (may be an opportunity if
positive deviance factors can be identified)
• Political context
Selected Opportunities:
• Defined MOH policy for anemia control & best practices
• Country initiatives: PMI, Feed the Future, etc.
• Many strong partners on the ground for many years (HKI, others)
• Many engaged community leaders & RC/ASC
52 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 26
27. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
THANK YOU
Expert Commentary
Questions
Q ti
Instructions for Small Group Work
53 53
Moving From Assessment to Implementation:
Group Work
• Applying Consolidated Framework for Implementation
Research (CFIR)
• Applying Breakthrough Series Collaborative Improvement
Methods (Systems-focused QI methodology)
54 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 27
28. Kathleen Hill & Evelyn Kamgang CORE Spring Meeting May 2012
Breakthrough Series Collaborative
Improvement Methodology
55 USAID HEALTH CARE IMPROVEMENT PROJECT
USAID Health Care Improvement Project./URC 28