This segment devoted mostly to preventive aspect which would be covered mainly through IYCF strategy. Under the strategic design, with special emphasis on the poor and disadvantaged, the community will be sensitized so that they are aware of malnutrition, how to identify, care and manage it. They are counselled to recognize a possible case of acute malnutrition and seek health care either through the Lady Health Worker, Community Midwives in their respective area to be maximally covered or through selected private sector organizations / NGOs in the rest uncovered areas at the appropriate level of health care delivery system.
The community outreach activities will be performed by LHWs/CMWs and the CHWs hired by the NGOs once onboard .The services provided will be:
Screening and identification of women and children for malnutrition in their assigned areas
Referring severe malnourished children to Outpatient Therapeutic Program (OTPs) /NSC (depending on the presence of complications ) for further evaluation and treatment
Follow up of the admitted malnourished cases in OTP and SC.
They will spread the health education messages themselves and via mother support groups they create in the community
Counseling of women for positive behaviors towards Infant and Young Child Feeding (IYCF) like early initiation of BF and continuous BF for 6 months ,
maternal nutrition ,
antenatal and post-natal care of the new born ,
CMAM sensitization ,
Basic hygiene practices.
They will also share the recipes of high energy diet for the children with the mothers
Awareness on usage of Iodized salt
The NGO will hire Community Health Workers and will also cover, community mobilization, formation of mother support groups, formation of community based organizations, screening of non-covered population by LHWs of the district and will work for behaviour change as well
is a broad scale movement to engage people's participation in achieving a specific development goal through self-reliant efforts.
It is a planned decentralized process that seeks to facilitate change for development through a range of players engaged in interrelated and complementary efforts.
It takes into account the felt needs of the people, embraces the critical principle of community involvement, and seeks to empower individuals and groups for action.
Infant Young Child Feeding (IYCF) and Community-based Management of Acute Malnutrition (CMAM) will be implemented through the existing public sector structures through two approaches:
Existing key community sectors and community groups: IYCF and CMAM need community mobilization especially poor and disadvantaged, which is an ongoing process that encompasses a wide range of activities done to help understand the affected communities, build a relationship with them, and foster their participation in program activities from the start and throughout the duration of the program.
Community mobilization can be done through four simple steps which ultimately contribute to efficiency of IYCF and CMAM programs in the communities.
The first step is identifying poor and disadvantaged sections of communities/households to focus them right from the beginning of the social mobilization process.
The second step is assessing community capacity. Assessing community capacity involves identifying the key persons of the community, including those of disadvantaged groups (Religious Leaders, Local Administrators, and Opinion Leaders, Political Leaders, Key Community Health Workers etc.) that would help to sensitize that community about the issue of acute malnutrition, IYCF and CMAM.
The third step is to identify groups (Women groups, Women’s Associations,Agricultural groups for farmers, Committees such as local Council, School Management, Parent Teacher Associations, School teachers and school children associations ,Youth Groups, occupational or religious and ethnic minority groups etc.) That has been created by communities themselves as well as those initiated and supported by NGO’s or the government. These groups can be important partners in all aspects of community mobilization.
The fourth step is to train Community Health Workers (CHWs), Community Resource Persons (CRPs) and Village Health Workers (VHWs) how to disseminate key messages about CMAM, IYCF and malnutrition in general. CHWs and VHWs can be trained using very simple methods to disseminate these key messages.
Private sector organization: Furthermore, in order to carry out community mobilization activities, private sector organizations, having prior community mobilization experience, will be hired through open bidding process and linked with the LHWs and CMWs for effective behavior change and community support. This will also have a threefold benefit of
Strengthening better targeting of poor and disadvantaged,
Strengthening community mobilization and skills of LHWs/CMWs; and
Enhancing the efforts for community support for nutrition related interventions.
This will be done through formation of the community support groups that include the disadvantaged, leading to community mobilization for positive nutrition behaviors and liaison with identified health facilities. In order to scale up nutrition interventions in the districts, a nutrition assistant will be hired through the project in every union council where there is not enough LHW coverage. Furthermore, in order to support the activities of the LHWs and CMWs, the existing supportive supervisory system of the National Program for Family Planning and Primary Health Care will be strengthened by enhancing their capacity.