Here are two case studies for your small groups to discuss:Case Study 1: You are the Country Director of a large nutrition program in Country X. The government has endorsed implementing the ENA framework at scale nationally. Your program supports the Ministry of Health. How would you work with different sectors to operationalize the ENA framework? What would be your first steps? Case Study 2: You are the Country Director of a large nutrition program in Country Y. The government is interested in mainstreaming nutrition but does not have the resources or capacity for a national scale up yet. They ask your program to pilot the ENA framework in 2 districts as a proof of concept. How would you design the pilot? What indicators would you use to
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Ähnlich wie Here are two case studies for your small groups to discuss:Case Study 1: You are the Country Director of a large nutrition program in Country X. The government has endorsed implementing the ENA framework at scale nationally. Your program supports the Ministry of Health. How would you work with different sectors to operationalize the ENA framework? What would be your first steps? Case Study 2: You are the Country Director of a large nutrition program in Country Y. The government is interested in mainstreaming nutrition but does not have the resources or capacity for a national scale up yet. They ask your program to pilot the ENA framework in 2 districts as a proof of concept. How would you design the pilot? What indicators would you use to
Ähnlich wie Here are two case studies for your small groups to discuss:Case Study 1: You are the Country Director of a large nutrition program in Country X. The government has endorsed implementing the ENA framework at scale nationally. Your program supports the Ministry of Health. How would you work with different sectors to operationalize the ENA framework? What would be your first steps? Case Study 2: You are the Country Director of a large nutrition program in Country Y. The government is interested in mainstreaming nutrition but does not have the resources or capacity for a national scale up yet. They ask your program to pilot the ENA framework in 2 districts as a proof of concept. How would you design the pilot? What indicators would you use to (20)
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Here are two case studies for your small groups to discuss:Case Study 1: You are the Country Director of a large nutrition program in Country X. The government has endorsed implementing the ENA framework at scale nationally. Your program supports the Ministry of Health. How would you work with different sectors to operationalize the ENA framework? What would be your first steps? Case Study 2: You are the Country Director of a large nutrition program in Country Y. The government is interested in mainstreaming nutrition but does not have the resources or capacity for a national scale up yet. They ask your program to pilot the ENA framework in 2 districts as a proof of concept. How would you design the pilot? What indicators would you use to
- 1. How to translate the nutrition momentum into countries? Lessons Learned from previous program on implementing the ENA framework Jennifer Nielsen HKI Agnes Guyon SPRING/JSI Core Group – Fall meeting 2012
- 2. What is the difference between ENA and IYCF? What is the difference between ENA and Lancet High Impact Nutrition Interventions?
- 3. The Essential Nutrition Actions Nutritional Care Optimal Complementary Women’s Nutrition Breastfeeding of the sick & Feeding with BF Malnourished child Control of Vitamin A deficiency Control of Control of Iodine Anemia Deficiency Disorders
- 4. Window of opportunity 1,000 days from conception to two years nutrition of girls & women especially pregnant and lactating infant & young children, especially 0-24 months 4
- 5. What is the history of ENA?
- 6. History of ENA since its birth in 1997 Nutrition Minimum Package (MINPAK) 1997
- 7. History of ENA Nutrition Essentials 1999 Essential Nutrition Actions coined in the USAID supported program in Madagascar
- 8. Today… consensus now exists on ‘what’ nutrition actions make a difference… The Lancet Series on Maternal and Child Undernutrition 2008 8
- 9. Lancet ‘Scaling Up Nutrition Framework for Action’ 9
- 10. Great similarity… Essential Nutrition Actions, The Lancet and The SUN Framework for Action Optimal Nutritional Care Complementary of the sick & Breastfeeding Feeding with BF Malnourished child Women’s Nutrition Control of Vitamin A deficiency Control of Control of Iodine Anemia Deficiency Disorders 10
- 11. Today… Agreement on the ‘what’ Challenge is now the ‘how’: operationalizing how to mainstream these 7 ENAs ‘at large scale’ to achieve a public health impact “The ENA framework” 11
- 12. Countries with ENA* … Indonesia India Cambodia Bangladesh Nepal * Various levels of engagement from ENA at community level only to ENA at national level. 12
- 13. What are the objectives of the ENA framework? What is the framework?
- 14. Consider the huge number of missed opportunities Source: World Bank, HNP
- 15. Operationalize nutrition support at large scale How do we reduce the ‘missed opportunities’ to support nutrition in existing programs? How do we mainstream into existing programs both inside and outside the health sector? And, how do we roll out the ENA framework to achieve large scale?
- 16. ENA framework extends nutrition coverage within the health sector… Child Health Nutrition programs Newborn health Reproductive Health From policy to delivery EPI Lactation Amenorrhea Method Community IMNCI/CCM with Family Planning Health facilities IMNCI Maternal Health CMAM Infectious Diseases Control of Malaria (Insecticide Treated Nets & Treatment) Tuberculosis HIV/AIDS (PMTCT) 16
- 17. Critical health contacts for infant feeding, micronutrients & women’s nutrition PREGNANCY: diet, iodized DELIVERY: Cord clamping, salt, iron/folic acid, de- Initiation BF, vitamin A, worming, anti-malarial, iron/folic acid, diet prep to BF. POSTNATAL AND FAMILY IMMUNIZATION: BF & CF, PLANNING: LAM & BF, vitamin A, de-worming, diet, iron/folic acid, treat assess and treat anemia anemia WELL CHILD & GMP monitor growth, assess and SICK CHILD & SAM/MAM:, counsel on IYCF feeding, counsel on IYCF, iodized assess and treat for anemia, check and complete 17 salt vitamin A, de-worming,
- 18. ENA framework extends nutrition coverage outside the health sector… Food Production Food Security From policy to delivery Pre-Service Water and Education Climate Change Sanitation Women in Schools Development Mass Media
- 19. ENA framework create the buzz at community level… Agriculture Education Community Health Workers Savings groups Local Development & Planning
- 20. BCC the backbone for the ENA framework Promote small do-able actions to demystify nutrition Harmonization through various tools Poopy and Counseling cards radio/TV Posters Newsletters Job aids Health booklet Formative Research to help over-come family and community obstacles
- 21. BCC: build on partners what already exists 1. Inter-personal counseling Health provider with mother Community worker with mother Mother-to-mother Peer counseling 2. Group discussions Breastfeeding support groups Savings & credit groups Homestead food production groups Listening clubs (cassettes and radio) 3. Informal settings Market days Fetching water or wood 4. Mass media Radio 21 Village theatre groups
- 22. Ultimate goal: saturate the environment with nutrition practices Enroll a large number of volunteers across sectors Health workers Community volunteers supporting Community assisting at health mothers volunteer making clinic home visits Community volunteers supporting women at chance Community health encounters (market, fields, festivals Agricultural extension collecting firewood) workers supporting mothers
- 23. Small Group Work Each group discuss a case study (20 minutes) Report back (5 minutes) Question: If you were Country Director…
Hinweis der Redaktion
- We focused our efforts in these countries with the objective of showing behavior change impact at scale. In each country there was a sizeable catchment area population ranging in size from a million to over 6 million people across multiple districts and regions.
- We focused our efforts in these countries with the objective of showing behavior change impact at scale. In each country there was a sizeable catchment area population ranging in size from a million to over 6 million people across multiple districts and regions.
- We focused our efforts in these countries with the objective of showing behavior change impact at scale. In each country there was a sizeable catchment area population ranging in size from a million to over 6 million people across multiple districts and regions.