Community Based Management of Acute Malnutrition according UNICEF and WHO standards Implementation in Oromia Region, Ethiopia WIth Pablo Horstmann Foundation and Alegria Sin Fronteras

1. ECC-SDCOM PABLO HORSTMANN FOUNDATION
CMAM Project: Nutrition Intervention through
Community Based Management of Acute Malnutrition
Terminal Presentation
Ashemi Dale (BSc in HO)
ECC-SDCOM
Pablo Horstmann Foundation
Murch/ 2017
Meki ,Ethiopia

2. 1. Presentation out line
1 Cover Page
2 Project Profile
3 Donation
4 Target group
5 Area of operation
6 Project goal
7 Project objectives
8 Budget
9 Activities vs Achievement
10 Budget utilization
12 Challenges & measures taken
13 Lesson learned
14 Conclusion
15 Recommendation

3. 2. Project Profile
PROJECT TITLE
“Nutrition Intervention through Community Based
Management of Acute Malnutrition (CMAM)” Project
GENERAL OBJECTIVE
To contribute to the reduction of morbidity and mortality of children
under 5 years and Pregnant and Lactating Women (PLW) in 8
Kebele of Dugda District of East Shao Zone by reaching severely
malnourished children with the outpatient and inpatient treatment
modalities (programs).
PROJECT DURATION March 2016 – December 2016 ( 9 months)
AREA OF OPERATION
Oro mía región, East Shao Zone, Dugda Woreda, 8 kebele (Ate
Lema,
Mukuye Leman, Wedesha Orogocho, Mejana Lalu, Argo Gadilala,
Koto Biliti, Biliti Balewald, Burka Dambel)
TIME OF
COMMENCEMENT
Time of Commencement (Date of Agreement): March 2016

4. Project Profile…
BENEFICIARIES Beneficiaries category Male Female
Average monthly
beneficiaries
Direct
Children 6-59m SAM 47 51 98
Children 6-59 m MAM 333 357 690
PLW 735 735
Total 380 1143 1523
Indirect Mothers/caretakers 6976 6976

5. 3. Donors
CMAM project is supported by:
• Pablo Horstmann Foundation
• Alegría Sin Fronteras (ASF)

6. 4. Target group
Under five
children
Pregnant
women
Lactating
women

7. 5. Area of operation
Region
• Oromia
Zone
• East Shoa Zone
Woreda
• Dugda
Kebeles
• 1. Ate Leman, 2. Mukuye Leman , 3. Wedesha Orogocho , 4. Mejana
Lalu, 5. Argo Gadilala, 6. Koto Biliti, 7. Biliti Balewald , 8. Burka Denbal

8. CMAM Kebeles
1. Ate Leman
2. Mukuye Leman
3. Wedesha
Orogocho
4. Mejana Lalu
5. Argo Gadilal
6. Koto Bilit
7. Biliti Balewald
8. Burka Denbal
5. Area of operation

9. 6. Project goal
To fight against the famine and its
impact on the health of children
under-five years old, pregnant and
lactating women (PLW) caused by
the drought consequence of El
Niño phenomenon

10. 7. Project objectives
General Objective
•Improving health status of
children under 5 years, pregnant
and lactating women in 8
kebeles of Dugda Woreda.

11. Specific Objectives
To reduce the effects of malnutrition in under five children in eight
(8) kebeles
To identify children under 5 years malnourished children in eight
(8) kebeles, management and treatment according protocol.
To screen the Pregnant and Lactating women in same kebeles and
distribute Famix for those who are malnourished.
To train HEWs and other health professionals on nutritional
screening, management and treatment.

12. 8. Budget of the Project
• 983,635 ETBProgram
Cost
• 358,445 ETBAdmin Cost
• 1,342,080 ETBGrand Total

13. S.N Description of activities Unit of
measurement
Project
life plan
Achieve
ment
%tage
Remarks
1
Facilitate project agreement
with Zonal Sectors
number 1 1
100%
2
Elaborating questionnaires
and checklists to HEWs for
initial data collection and
screening
Number of
health
extension
workers 16 16 100%
3
Quarterly review meeting
with government health
professional staff
Number 3 4
133%
:
Activity Planned vs. Achievement

14. vs. Achievement…
4
Supervision of health post
Numbe
r of
visits 72 56 77.8%
Field activities
were held b/c of
the last situation
in the kebele
5
Recruitment of project staffs
Number
of staff 2 2 100%
6
Conduct launching workshop
number 1 1 100%
7
Selection of community
animators and facilitators
number 24 28 116.7%
Activity Planned vs. Achievement…

15. 8 Orienting animators
and facilitators
(Community Health
Volunteers)
number of
animators
oriented 24 28 116.7%
9 Beneficiary kebele
selection with medical
criteria and Dugda
Woreda Health Office
number of
kebele 8 8 100%
10 Community
mobilization in
targeted Kebele
number of
direct
beneficiaries 13707 14529
106%
11
Malnutrition Screening
of children under five
and PLW.
number of
direct
beneficiaries 13707 13573 99%
12
Treatment and follow
up of SAM children number of
The project had screened 99% of
the targeted group but 21 SAM is
detected & treated, we are happy
with this b/c our objective is not
aryof Activity Planned …Activity Planned vs. Achievement…

16. 13 Workshop and
training to HEW
number of
training 1 1
100%
14 Health information
and nutritional
counseling to the
community
number of
sessions in
each kebele 72 56 77.8%
Field activities were held
b/c of the last situation in
the kebele
16
Food transportation
to kebele
number of
quintals
transported
to all
kebeles 550 865.32 157.3%
It is over achievement b/c
lack of base line data
survey
17
Strengthening of
standard data base
for screening and
follow up number of
HEWs met 16 15 93.8%
of Activity Planned…Activity Planned vs. Achievement…

17. 18
Follow up of SAM
children weekly number of
visits of HPs 144 128 88.9%
19
Enrolling children,
pregnant & lactating
women to SFP
number of
direct
beneficiaries
13707 13837 100.95%
20
Focus group discussion
and community
conversation
number of
meetings
with
beneficiaries
in all HPs 72 56 77.8%
Field activities were held b/c
of the last situation in the
kebele
21
Distribution of
supplementary food to
moderate malnourished
children, pregnant &
lactating women
number of
days for
distribution
of famix 72 64 88.9%
SActivity Plan Vs Achievment…ummary
of Activity Planned…Activity Planned vs. Achievement…

18. 22
Conduct meeting with Woreda
nutritional task force committee
& joint monitoring
number of
meeting 3 1 33.33%
23
Reporting and documentation
number of
days reports
3 3
100%
24
Terminal evaluation
number
1 1
100%
U
Activity Plan Vs Achievements…mmary
of Activity Planned vs.
Achievement…
Activity Planned vs. Achievement…

19. S.
N Budget Plan Achievement %tage Remark
1
Program cost
983,635 1.447,524.53 147% Under planning Under
plan 2ndry to lack of
base line data survey
2 Admin cost
358,445 157,115.71 44% The rest is transferred
to Supplementary
Food purchase (Famix)
3 Total
1,342,080 1,604,640.24 120% Under plan 2ndry to
lack of base line data
survey
Budget utilization

20.  Presence of Severe rain fall in the intervention areas (There
was much rain fall which resulted in muddy roads so was
difficult to reach the operation areas in some weeks of the last
summer).
 The non-malnourished community come with the beneficiary
on Famix distribution day; even though they are not
beneficiaries & told that they are well nourished, raising
questions for famix.
Challenges

21.  Program over lapping due to HEWs are too busy with other
programs, government & other NOGs wants community.
 Held up of project field activities almost for more than a
month due to pervious situation in the kebele.
 Since it is a short time and emergency response project, it
lacks base line data survey
Challenges…

22.  Understand the situation in the project intervention areas, the
beneficiaries, paid attention for the project activities.
 Consequently, rescheduling & planning for uncomfortable
rainy days were one of measures taken as a mitigation
measures.
 Besides, those non-malnourished come with beneficiary
repeatedly nutritional counselling is given to them.
 Frequent and timely discussion, awareness raising and follow
up of the situation were made with relevant stakeholders.
 Even though, base line data survey was not done the project
could met its objectives.
Mitigation Measures

23.  How to work in team sprite for better achievement
 Sharing members work loads
 Community participation is the best tool to prevent
malnutrition from its grass root
 Beneficiary participation is the best tool to achieve a project
objectives
 Community behavioural Change takes time
 Lack of base line data leads to inappropriate planning
Lesson learnt

24. Conclusion: -
• Community based project Sustainability strengthening
governmental health network through HEWs, nutritional and
objective selection criteria that avoid conflicts
• The project targeted the most vulnerable groups of the
community in eight rural kebele of Dugda Woreda, through
community based approaching; involving the local community
health volunteers and HEWs in beneficiary selection process,
for different activities, process & management by them-selves
as per project planned.
Concluding

25. • Accordingly, the project intervened in flexible approaches;
targeted under-five children, pregnant and lactating women in
order to ensure project sustainability.
• It strengthened the standard database screening & built the
capacity of the Health Professionals, HEWs and community
health volunteers through their respective health posts.
• It helped Health Professionals, HEWs and volunteers to adopt
working in team & address serious problems associated, with a
dynamic team such as mobilizing local community for
community participation, and managing & revolving resources
with in HC & HPs.
Concluding …

26. • Nutritional counselling and related sanitation was promoted
through mass awareness creation and Health Education by
targeting the beneficiaries.
• For better awareness creation and smoothing the intervention,
the project used early innovators from the beneficiaries.
• This helped early initiating of breast feeding and proper
exclusive breast feeding, addressing important problems
associated with the bottle feeding, weight loss during
pregnancy and increasing acceptance of the mixed feeding
after six month of child ages in the community.
• Based on this, the project provides training to Health
Professionals & HEWs in practice.
Concluding …

27. • From all interventions measures, impacts were recorded in
accordance that could contribute in changing the nutritional
status of project beneficiaries.
• For accomplishing the project activities, strong collaboration
with project stakeholders (community and relevant line
departments) played a great role for the successfulness of the
project.
Concluding …

28. Recommendations
• The project was launched lately at the end of March 2016 due
to the delaines of project agreement signing by the concerned
government signatory offices.
• Nonetheless, due to high project team and government line
department commitment in using their maximum potential
output for addressing the project objectives, the need of
reaching the project beneficiaries was accomplished as per the
project plan successfully.
• The busy schedule of district government staffs due to frequent
meetings and acute watery diarrhoea out beak forced us to
postpone training of HEWs, workshop, meetings and
discussions.
Recommendations…

29. • In fine, frequent communication and flexibility to use free time
was the solution to overcome the problem.
• In fact, for the implementation of project activities time should
be used wisely and properly for by concerned project relevant
stakeholders for its betterment.
• This project faced lack of base line data survey and shortage of
time because of the instability in the last year.
• Understanding these problems, frequent and timely discussion,
mass screening, awareness creation and follow up of the
situation were made with relevant stakeholders by the project
implementers as a solution.
Recommendations

30. 15/04/2019 30