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Proposal Development on
Organizing Health Promotion Education Communication Training Program on
Maternal Infant and Young Child Nutrition Practices in Pumdi, Pokhara
Municipality 22.
Assignment Submitted by
Mohammad Aslam Shaiekh
Sarmila Baral
Submitted to
Prof. Dr Arun Kumar Koirala
Master of Public Health Program
School of Health and Allied Science
Faculty of Health Sciences
Pokhara University
Kaski, Nepal
July, 2019
2
1. HPEC Program Outline
Program Title Organizing HPEC training program on Maternal Infant
and Young child nutrition Practices in Pumdi, Pokhara
Municipality 22.
Description The HPEC program will be implemented in community
settings to promote the Maternal, infant and young child
nutrition practices among caregiver/mothers.
Implementing organization MPH students, Pokhara University
Partners SHAS, Pokhara University
Municipal health section, Pokhara Metropolitan
Program Area Pokhara 22- Pumdi
Date 1-7 August
Target Beneficiaries 150 (listed out from FCHVs)
INTRODUCTION
Background
Good nutrition is the bedrock of child survival, health and development. Well-nourished
children are better able to grow and learn, to participate in and contribute to their
communities
Nutrition education and counselling is a widely used strategy to improve the nutritional status
of women during pregnancy. The strategy focuses primarily on:
 promoting a healthy diet by increasing the diversity and amount of foods consumed
 promoting adequate weight gain through sufficient and balanced protein and energy
intake
 Promoting consistent and continued use of micronutrient supplements, food
supplements or fortified foods.
The period between conception and the age of two years that, with good health and nutrition
i.e MIYCN practices can mitigate the risks of malnutrition that hamper a child’s long-term
physical and cognitive development.
Infant and young child feeding practices have a direct effect on the nutritional status of
under two children which ultimately impact child survival.(WHO 2015). The optimal
feeding practices are poor with complementary feeding practices among 6 to 23 months
3
of age.(Basnet D, 2016). Good nutrition and dietary behaviours in childhood are important to
achieve full growth potential and appropriate body composition, to promote health and well-
being, and to reduce the risk of chronic diseases in adulthood. Growth continues at a steady
rate during childhood, then accelerates during adolescence, creating increases in nutrient
needs to support the rapid growth rate and increase in body weight. In addition to the impact
on growth and development, children’s diets are important to ensure overall health and well-
being. (Adhikari 2008).
Statement of Problem
In children under five years of age in Nepal, protein energy malnutrition is a common
problem. In Nepal, 36 percent of children under five years of age are stunted, 10 percent are
wasted, and 27 percent are underweight.
Stunting is more common in the mountain and hilly areas while wasting and underweight are
more common in Terai areas. Overall, 53% of children suffered from some degree of anemia:
26% were classified as mildly anemic, 26% were moderately anemic, and less than 1% were
severely anemic. The prevalence of anaemia decreases with age, ranging from a high of 74%
among children age 12-17 months to a low of 36% among children age 48-59 months.
About 24% of new-borns are born with low birth weight. Only 66% of infants get exclusive
breastfeeding in the first six months of life. Only 47 per cent children aged 6-23 months are
receiving diversified diets and 36 per cent of them receive a minimum acceptable diet.
The proportion of women (BMI less than 18.5, which indicates under nutrition) is 17% and
the prevalence of anaemia among pregnant women is 46%. NDHS, 2016
Rationale
Pumdi is one of the rural ward although it falls under Pokhara Metropolitan. Research
conducted on Pumdi, Kaski showed that the higher proportion of malnutrition among primary
students (5-10yrs). The study revealed 35.4%, 44.2%, 12.3% prevalence rate of underweight,
stunting and wasting respectively.(B sanju, Acharya B 2015) So we would like to conduct
HPEC program targeting golden 1000 days. The first 1,000 days from the start of a woman’s
pregnancy to a child’s second birthday offer an extraordinary window of opportunity for
preventing undernutrition and its consequences. About 80% of mental development occurs
within 2 years of age We need to target our actions to this critical period, using widely
accepted and evidence-based interventions, including support for breastfeeding, appropriate
complementary foods for infants over six months, and micronutrient supplementation for
4
women and children to address deficiencies. These investments in nutrition – particularly in
the earliest years of life – can yield dramatic results for children, their families, and
communities.
Goal
To improve health and nutritional status of pregnant, lactating women, and children under
two years of age by nutrition education activities.
Objectives
General Objective
To impart MIYCN Knowledge and behaviours to the pregnant women and mother of under
two years of age.
Specific Objectives
All the Participants will be able to
 Describe the importance of nutrient rich foods for pregnant, lactating and children of
under 2 years of age
 State importance and benefits of colostrum feeding, early initiation and exclusive
breastfeeding
 Show appropriate positioning and attachment of breastfeeding
 Make super flour and porridge by using locally available foods
 Describe complementary feeding behaviors
 State the importance of essential hygiene action and measures of water purification
 Describe importance and benefits of kitchen garden at home
Implementation Strategy
 Interaction with local Health workers and FCHVs about program.
 Mobilization of FCHVs to inform pregnant and mothers of under 2years of children.
5
Approaches
At first, Formal letter will be made and get permission from School of Health and Allied
Sciences. We will also get permission from Municipal health section and respective ward
office. Interaction program will be conducted with presence of FCHVs and Health workers at
local health facility before program implementation and 5 different places will be decided to
conduct the HPEC program.
Expected Outcome
1. All pregnant and lactating women will get information about importance of nutrition
to them and adopt healthy behavior
2. All the participants will know the importance and benefits of colostrum feeding, early
initiation and exclusive breastfeeding.
3. All the participants will know the proper positioning and attachment during
breastfeeding
4. All the participants will know foods and behaviors of complementary feeding
according to
Age, Variety, Frequency, Timing, Thickness, Active feeding and Sanitation
5. All the participants will know the importance of 4 types of food a day and process of
making healthy foods by using locally available foods.
6. Information about locally available foods and division
7. Process of making super flour and nutritious porridge at home
8. All the participants will know and adopt the importance of essential hygiene action
and measures of water purification
9. Describe importance and benefits of kitchen garden at home
6
Detail plan of action for health education
S.N Activities Methods/media Responsible
person
settings Time & date
1. Describe the
importance of
nutrient rich
foods for
pregnant,
lactating and
children of
under 2 years
of age
-Interaction and
Lecture
discussion
- Use of PPT,
IEC Materials
like poster,
pamphlets.
- MD. Aslam Community 10:0-10:45
2 Benefits of
colostrum
feeding, early
initiation and
exclusive
breastfeeding
-Interaction and
Lecture
discussion
- Use of PPT,
IEC Materials
like poster,
pamphlets.
- MD. Aslam
- Sarmila Baral
Community 10:45-11:15
3 Show
appropriate
positioning and
attachment of
breastfeeding
-Demonstration
for proper
positioning and
Attachment
-Video Shows
for Information
sharing
Sarmila Baral Community 11:15-12:00
5 Describe
complementary
feeding
behaviors
-Interaction and
Lecture and
discussions
Media: Use of
PPT, IEC
Sarmila Community 12:00-1:00
7
Materials like
poster,
pamphlets.
Lunch Break(1:00-2:00)
4 Make super
flour and
porridge by
using locally
available foods
-Demonstration
-Video Shows
for Information
sharing
- MD. Aslam
- Sarmila Baral
Community 2:00-3:00
6 State the
importance of
essential
hygiene
actions and
measures of
water
purification
-Interaction and
Lecture
- Use of PPT,
IEC Materials
like poster,
pamphlets.
- MD. Aslam Community 3:00-3:45
7 Importance
and benefits of
kitchen
gardening
-Brainstorming
-Group
discussion
-Lecture
- photo/ video
shows
MD. Aslam
Sarmila
Community 3:45:4:45
8 Review from
participants
4:45-5:00
9  Participants commitment to adopt healthy
behaviour and convey messages to
community people
 Closing the program
5:00:5:20
8
Evaluation Plan:
Training evaluation
Evaluation will be done on basis of discussion with participants at last session of program.
 Pre test -Post test evaluation will be done
Outcome Evaluation:
Field visit will perform after 12 weeks to evaluate HPEC at community level.
 Interview for Knowledge assessment
 Observation for breastfeeding, complementary feeding
 Observation of kitchen garden
 Observation for EHA
9
Work Plan
Activities July 2019 August 2019
3rd
week
4th
week
1st
week
2nd
week
Need assessment(thesis review)
Proposal development
Interaction and orientation about the programme
Selection of target group and identify the place of
health promotion, education and communication
programs
Conduct health education session
Networking and coordination
monitoring and evaluation
Report writing and evaluation
10
Budget Plan
SN Particulars/Activities Unit Rate Quantity Day Amount Rema
rks
Interaction program
1 Stationaries Person 100 30 1 3,000
2 Snacks and Refreshment Person 150 30 1 4500
3 Media coverage Lumsum 5000
Health promotion, education
program
1 Stationaries(marker,
newsprint, poster, flip chart)
PC lumsum 5 5000
2 Banner PC 500 1 5 500
3 Food ingredient for
demonstration during HPEC
program
5000 Lumsum 5000
4 Soap, bucket, mug for EHA PC 400 1 1 400
5 Refreshments for
participants
150 32 5 24000
6 Projector in rent pc 1000 1 5 5000
7 Hall rent for program 1000 5 1 5000
Travel allowance Person 200 2 6 2400
Report printing and binding 1000 Lumsum 1000
Miscellaneous 3040
Total Nrs. 63840/
11
References
 World Health Organization & UNICEF. Indicators for assessing infant and young
child feeding practices. 2008 Retrieved September 5, 2015 from http://www.unhcr.
org/4b752d509
 DoHS. Nepal Demographic Health Survey, Ministry of Health and Population,
Kathmandu, 2016.
 Basnet, D., 2016. Infant and Young Child Feeding Practices among Mothers at
Chapagaun VDC. J. Nepal Health Res. Counc.
https://doi.org/10.33314/jnhrc.v14i2.800
 (PDF) Nutritional Status of Primary School Children in Pumdi Bhumdi Village of
Kaski District, Nepal [WWW Document], n.d. URL
https://www.researchgate.net/publication/275953773_Nutritional_Status_of_Primary_
School_Children_in_Pumdi_Bhumdi_Village_of_Kaski_District_Nepal (accessed
7.30.19).

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Proposal Development on Organizing Health Promotion Education Communication Training Program on Maternal Infant and Young Child Nutrition Practices in Pumdi, Pokhara Municipality 22.

  • 1. Proposal Development on Organizing Health Promotion Education Communication Training Program on Maternal Infant and Young Child Nutrition Practices in Pumdi, Pokhara Municipality 22. Assignment Submitted by Mohammad Aslam Shaiekh Sarmila Baral Submitted to Prof. Dr Arun Kumar Koirala Master of Public Health Program School of Health and Allied Science Faculty of Health Sciences Pokhara University Kaski, Nepal July, 2019
  • 2. 2 1. HPEC Program Outline Program Title Organizing HPEC training program on Maternal Infant and Young child nutrition Practices in Pumdi, Pokhara Municipality 22. Description The HPEC program will be implemented in community settings to promote the Maternal, infant and young child nutrition practices among caregiver/mothers. Implementing organization MPH students, Pokhara University Partners SHAS, Pokhara University Municipal health section, Pokhara Metropolitan Program Area Pokhara 22- Pumdi Date 1-7 August Target Beneficiaries 150 (listed out from FCHVs) INTRODUCTION Background Good nutrition is the bedrock of child survival, health and development. Well-nourished children are better able to grow and learn, to participate in and contribute to their communities Nutrition education and counselling is a widely used strategy to improve the nutritional status of women during pregnancy. The strategy focuses primarily on:  promoting a healthy diet by increasing the diversity and amount of foods consumed  promoting adequate weight gain through sufficient and balanced protein and energy intake  Promoting consistent and continued use of micronutrient supplements, food supplements or fortified foods. The period between conception and the age of two years that, with good health and nutrition i.e MIYCN practices can mitigate the risks of malnutrition that hamper a child’s long-term physical and cognitive development. Infant and young child feeding practices have a direct effect on the nutritional status of under two children which ultimately impact child survival.(WHO 2015). The optimal feeding practices are poor with complementary feeding practices among 6 to 23 months
  • 3. 3 of age.(Basnet D, 2016). Good nutrition and dietary behaviours in childhood are important to achieve full growth potential and appropriate body composition, to promote health and well- being, and to reduce the risk of chronic diseases in adulthood. Growth continues at a steady rate during childhood, then accelerates during adolescence, creating increases in nutrient needs to support the rapid growth rate and increase in body weight. In addition to the impact on growth and development, children’s diets are important to ensure overall health and well- being. (Adhikari 2008). Statement of Problem In children under five years of age in Nepal, protein energy malnutrition is a common problem. In Nepal, 36 percent of children under five years of age are stunted, 10 percent are wasted, and 27 percent are underweight. Stunting is more common in the mountain and hilly areas while wasting and underweight are more common in Terai areas. Overall, 53% of children suffered from some degree of anemia: 26% were classified as mildly anemic, 26% were moderately anemic, and less than 1% were severely anemic. The prevalence of anaemia decreases with age, ranging from a high of 74% among children age 12-17 months to a low of 36% among children age 48-59 months. About 24% of new-borns are born with low birth weight. Only 66% of infants get exclusive breastfeeding in the first six months of life. Only 47 per cent children aged 6-23 months are receiving diversified diets and 36 per cent of them receive a minimum acceptable diet. The proportion of women (BMI less than 18.5, which indicates under nutrition) is 17% and the prevalence of anaemia among pregnant women is 46%. NDHS, 2016 Rationale Pumdi is one of the rural ward although it falls under Pokhara Metropolitan. Research conducted on Pumdi, Kaski showed that the higher proportion of malnutrition among primary students (5-10yrs). The study revealed 35.4%, 44.2%, 12.3% prevalence rate of underweight, stunting and wasting respectively.(B sanju, Acharya B 2015) So we would like to conduct HPEC program targeting golden 1000 days. The first 1,000 days from the start of a woman’s pregnancy to a child’s second birthday offer an extraordinary window of opportunity for preventing undernutrition and its consequences. About 80% of mental development occurs within 2 years of age We need to target our actions to this critical period, using widely accepted and evidence-based interventions, including support for breastfeeding, appropriate complementary foods for infants over six months, and micronutrient supplementation for
  • 4. 4 women and children to address deficiencies. These investments in nutrition – particularly in the earliest years of life – can yield dramatic results for children, their families, and communities. Goal To improve health and nutritional status of pregnant, lactating women, and children under two years of age by nutrition education activities. Objectives General Objective To impart MIYCN Knowledge and behaviours to the pregnant women and mother of under two years of age. Specific Objectives All the Participants will be able to  Describe the importance of nutrient rich foods for pregnant, lactating and children of under 2 years of age  State importance and benefits of colostrum feeding, early initiation and exclusive breastfeeding  Show appropriate positioning and attachment of breastfeeding  Make super flour and porridge by using locally available foods  Describe complementary feeding behaviors  State the importance of essential hygiene action and measures of water purification  Describe importance and benefits of kitchen garden at home Implementation Strategy  Interaction with local Health workers and FCHVs about program.  Mobilization of FCHVs to inform pregnant and mothers of under 2years of children.
  • 5. 5 Approaches At first, Formal letter will be made and get permission from School of Health and Allied Sciences. We will also get permission from Municipal health section and respective ward office. Interaction program will be conducted with presence of FCHVs and Health workers at local health facility before program implementation and 5 different places will be decided to conduct the HPEC program. Expected Outcome 1. All pregnant and lactating women will get information about importance of nutrition to them and adopt healthy behavior 2. All the participants will know the importance and benefits of colostrum feeding, early initiation and exclusive breastfeeding. 3. All the participants will know the proper positioning and attachment during breastfeeding 4. All the participants will know foods and behaviors of complementary feeding according to Age, Variety, Frequency, Timing, Thickness, Active feeding and Sanitation 5. All the participants will know the importance of 4 types of food a day and process of making healthy foods by using locally available foods. 6. Information about locally available foods and division 7. Process of making super flour and nutritious porridge at home 8. All the participants will know and adopt the importance of essential hygiene action and measures of water purification 9. Describe importance and benefits of kitchen garden at home
  • 6. 6 Detail plan of action for health education S.N Activities Methods/media Responsible person settings Time & date 1. Describe the importance of nutrient rich foods for pregnant, lactating and children of under 2 years of age -Interaction and Lecture discussion - Use of PPT, IEC Materials like poster, pamphlets. - MD. Aslam Community 10:0-10:45 2 Benefits of colostrum feeding, early initiation and exclusive breastfeeding -Interaction and Lecture discussion - Use of PPT, IEC Materials like poster, pamphlets. - MD. Aslam - Sarmila Baral Community 10:45-11:15 3 Show appropriate positioning and attachment of breastfeeding -Demonstration for proper positioning and Attachment -Video Shows for Information sharing Sarmila Baral Community 11:15-12:00 5 Describe complementary feeding behaviors -Interaction and Lecture and discussions Media: Use of PPT, IEC Sarmila Community 12:00-1:00
  • 7. 7 Materials like poster, pamphlets. Lunch Break(1:00-2:00) 4 Make super flour and porridge by using locally available foods -Demonstration -Video Shows for Information sharing - MD. Aslam - Sarmila Baral Community 2:00-3:00 6 State the importance of essential hygiene actions and measures of water purification -Interaction and Lecture - Use of PPT, IEC Materials like poster, pamphlets. - MD. Aslam Community 3:00-3:45 7 Importance and benefits of kitchen gardening -Brainstorming -Group discussion -Lecture - photo/ video shows MD. Aslam Sarmila Community 3:45:4:45 8 Review from participants 4:45-5:00 9  Participants commitment to adopt healthy behaviour and convey messages to community people  Closing the program 5:00:5:20
  • 8. 8 Evaluation Plan: Training evaluation Evaluation will be done on basis of discussion with participants at last session of program.  Pre test -Post test evaluation will be done Outcome Evaluation: Field visit will perform after 12 weeks to evaluate HPEC at community level.  Interview for Knowledge assessment  Observation for breastfeeding, complementary feeding  Observation of kitchen garden  Observation for EHA
  • 9. 9 Work Plan Activities July 2019 August 2019 3rd week 4th week 1st week 2nd week Need assessment(thesis review) Proposal development Interaction and orientation about the programme Selection of target group and identify the place of health promotion, education and communication programs Conduct health education session Networking and coordination monitoring and evaluation Report writing and evaluation
  • 10. 10 Budget Plan SN Particulars/Activities Unit Rate Quantity Day Amount Rema rks Interaction program 1 Stationaries Person 100 30 1 3,000 2 Snacks and Refreshment Person 150 30 1 4500 3 Media coverage Lumsum 5000 Health promotion, education program 1 Stationaries(marker, newsprint, poster, flip chart) PC lumsum 5 5000 2 Banner PC 500 1 5 500 3 Food ingredient for demonstration during HPEC program 5000 Lumsum 5000 4 Soap, bucket, mug for EHA PC 400 1 1 400 5 Refreshments for participants 150 32 5 24000 6 Projector in rent pc 1000 1 5 5000 7 Hall rent for program 1000 5 1 5000 Travel allowance Person 200 2 6 2400 Report printing and binding 1000 Lumsum 1000 Miscellaneous 3040 Total Nrs. 63840/
  • 11. 11 References  World Health Organization & UNICEF. Indicators for assessing infant and young child feeding practices. 2008 Retrieved September 5, 2015 from http://www.unhcr. org/4b752d509  DoHS. Nepal Demographic Health Survey, Ministry of Health and Population, Kathmandu, 2016.  Basnet, D., 2016. Infant and Young Child Feeding Practices among Mothers at Chapagaun VDC. J. Nepal Health Res. Counc. https://doi.org/10.33314/jnhrc.v14i2.800  (PDF) Nutritional Status of Primary School Children in Pumdi Bhumdi Village of Kaski District, Nepal [WWW Document], n.d. URL https://www.researchgate.net/publication/275953773_Nutritional_Status_of_Primary_ School_Children_in_Pumdi_Bhumdi_Village_of_Kaski_District_Nepal (accessed 7.30.19).