Community based Management of Acute Malnutrition in 13 union councils of Layyah District, Punjab -Pakistan
The overall goal of the proposed project is to reduce less than five mortality and prevent escalation of malnutrition by providing effective nutritional services that meet national and internationally recommended minimum standard of care for population affected by emergency.
Main Activities of the Project:
Training of Project staff and 15 health facilities staff on Community Management of Acute Malnutrition [(CMAM), comprising of i. Community outreach ii. Supplementary Feeding Program, iii. Outpatient Therapeutic Program and Referral of complicated cases of severe acute malnutrition for stabilization care)
Training of staff on CMAM and IYCF guidelines and protocols will be conducted by Relief International’s Master Trainers in collaboration with UNICEF.
Training of Lady health Workers (LHWs) on nutritional anthropometry on the basis of Mid Upper Arm Circumference (MUAC) and weight/height
Screening of 100% eligible children (6-59 months) and women (pregnant/ lactating) in the community using MUAC and in facility using weight and height.
Establishing supplementary feeding program (SFP) for provision of supplementary foods Wheat Soya Blend, fortified oil, supplementary plumpy, multi-micronutrient supplements (sachets and tablets and Fe/Folic Acid) and other routine medicine (De-worming tablets, anti-malarials, Vitamin A), provided by UNICEF in collaboration with WFP will be distributed to target beneficiaries as per CMAM guidelines.
Establishing outpatient patient therapeutic program (OTP) for severely acute malnourished children in the selected health facilities of the target District
Ready to Use Therapeutic Foods-RUTF (Plumpy Nut /) and routine medicines (Amoxicillin, chloromphenicol, antimalarials, deworming tablets and vitamin A provided by UNICEF will be provided to all eligible children (6-59 months).
Establishment of breast feeding corners (safe heavens) in the target health facilities for promotion of exclusive breastfeeding up to six months of age and appropriate complementary feeding and encouraging/ helping mothers for re-lactation.
Health, Nutrition and Hygiene Promotion sessions for adopting nutrition and health practices and behavior change through interpersonal communication (IPC), Interactive Group Sessions using Behaviour Change Communication strategies. Focus Group Discussions (FDGs) with mothers on Exclusive Breast feeding up to six months of age, appropriate complementary feeding and community motivation for early detection of severe acute malnutrition will be conducted health and nutrition promoters
Generate and provide to UNICEF and concerned district health authorities weekly and monthly health and nutritional surveillance reports.
Trainings of Government Health Care Providers on “Community Based Management of Acute Malnutrition”
Training of project staff on “ Community Based Management of Acute Malnutrition” (CMAM) and “ Infant Young Child Feeding Practices (IYCF)
Health and Hygiene promotion sessions for school children
Community awareness session to promote breast feeding and other preventive measures to decrease incident rate and prevalence of severe Acute Malnutrition in children(6-59 months, Pregnant women and lactating mothers
Establishment of breast feeding corners
40 health care providers of the Government t health facilities were trained on community based management of a acute malnutrition and Infant young child feeding practices
311 lady health workers were trained on community outreach nutritional screening of children, pregnant women and lactating mothers. They also trained on proper referral mechanism and follow up procedures and motivational skills for the defaulters clients.
13 breast feeding corners were established at 13 health facilities to promote breast feeding
1504 sessions on IYCF and nutrition education were conducted
20499 mother received counseling on exclusive breast feeding and timely introduction of appropriate complementary feeding.
23,116 mothers educated on use of multi micronutrient sachets
910 community awareness sessions on for the male and female were conducted on malnutrition issues and the role of community to minimize the incidence and prevalence rate of malnutrition. During these sessions 2456male and 3890 female were educated
Goods & Services Delivered:
19,130 male children and 21480 female children were screened to check their nutrition condition
27,778 pregnant women and lactating mother were screened to check nutritional condition
3813 moderately malnourished children treaded in supplementary feeding program
3432 both pregnant women and lactating mothers cured of moderate malnourishment
200 severely malnourished children with medical complications were treated in stabilization center
487 severely malnourished children without medical complications were treated as outdoor patient
Food Distributed (MT)
Wheat Soya blend
High Energy Biscuit (HEB)
Description of Items
Multiple micronutrient pdr,sach./PAC-30
Micronutrient, film-coated tabs/PAC-1000
Folic acid 5mg tabs/PAC-1000
Therapeutic spread,sachet 92g/CAR-150
F-75 therapeutic diet,sachet,410g/CAR-20
F-100 therapeutic diet,sach. 456g/CAR-30
ReSoMal,84g sachet for 2 litres/CAR-130
Amoxici.pdr/oral sus 125mg/5ml/BOT-100ml
Paracetamol 125mg/5ml elixir/BOT-60ml
Ferrous sulp.oral sol. 125mg/ml/BOT-30ml
Mebendazole 500mg tabs/PAC-100
Chloroquine syrup 50mg/5ml/BOT-60ml
Nystatin oral sus 100,000IU/ml/BOT-30ml
Benzyl benzoate 25% lotion /BOT-1000ml
Tetracycline eye ointment 1%/TBE-5g
Ampicillin pdr/inj 500mg vial/BOX-25
Metronidazole inj 500mg/100ml vl/BOX-50
MUAC,Child 11.5 Red/PAC-50
MUAC,Adult,without colour code/PAC-50
Scale, electronic,mother/child, 150kgx100g
Scale,baby,electronic,10kg,<5g> for SCs
HEIGHT MEASURING BOARD
# Children received multi micronutrient sachets
# Pregnant women and lactating mothers received Multi micronutrient tablets with MM tablets
# Pregnant women and lactating mothers with Folic Acid
# Children Dewormed
The project was implemented in collaboration with District health Department and the health care providers were full on board in the implementation of the project activities. Insert types of infrastructure or organizational units that will continue to provide benefits post project
Community based management of Acute malnutrition is a technical project and the health care providers were trained on the identification, management and prevention of acute malnutrition.
95 % of the project staff was local and 90 percent female, this an added advantage that from each locality there is some trained health& nutrition care providers. They are the permanent trained and skilled assets of the communities concerned
Community mobilization realized the communities that malnutrition is a condition that exist in their communities and is curable and preventable
15 government health facilities were involved in the project activities and they are now equipped with knowledge, skills and anthropometric instruments.
Involvement of lady health Workers of national program is a significant step, that ensures the sustainability of interventions because the lady health workers program is a Government Program and operates through the gross root level
Overwhelming female participation both as service provider and beneficiaries paved the way to rely on the services of NGO’s and a breakthrough to get out of homes the educated female from house and serve for their own communities
Medical officers and Lady health of 15 health facilities were involved in the CMAM Project activities Period of Data August 04,2010 – August 31,2011