RP Updates

Pakistan Flood Response  
save lives of malnourished children (6-59 months) and to ensure that GAM (Global Acute Malnutrition) rate in
the affected area is maintained below the 10% emergency threshold by improving nutritional status through provision of effective nutritional services at the community and facility level.....
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  Successful Stories
When my son was admitted to SC, I and my Husband were very worried. We didn’t know what is wrong with our child, he always remains ill,” says her mother. We have consulted every doctor but after sometime he became again ill. Then there i was told about malnutrition and that a malnourished child is more prone to disease. We need food to stay alive, but also to stay strong. Without proper nutrition, our immune system is not efficient, so disease enters through germs like bacteria and can attack easily. Then a cycle begins, when we have a disease, we become malnourished more easily. But now I am confident because now my baby is healthy and I know how to save my children from malnutrition within my economic limits. Thanks to the programme like this.
She said that when i came SC i was so worried and hopeless that now my child will not survive. But there she recovered very soon. and she was also counseled about how she can manage her child health living within her economic limits at SC. She said I used to think that as I am not giving powder milk to my child so she is week. But she was discharged from Sc and referred to SFP with the impression that natural vegetables, fruit, food are best for child health and growth. And diseases can be avoid through cleanliness In SFP center extensive counseling made her concepts more clear and gave them strength. Following the instructions of Nutrition Assistant she fed her child with the Supplementary Plumpy and Multi-Micro Nutrient sachets and her health improved quickly.
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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.

Capacity Built:  
  • 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

    Commodity Food Distributed (MT)
    Wheat Soya blend 67.071
    Supplementary Plumpy 36.768854
    Vegetable Oil 41.4895
    High Energy Biscuit (HEB) 31.1164965
    Total 176.4458505

    Sl. No. Description of Items Unit Quantity distributed
    1 Multiple micronutrient pdr,sach./PAC-30 CTN 138
    2 Micronutrient, film-coated tabs/PAC-1000 PACK 250
    2 Folic acid 5mg tabs/PAC-1000 PACK 322
    3 Therapeutic spread,sachet 92g/CAR-150 CTN 680
    3 F-75 therapeutic diet,sachet,410g/CAR-20 CTN 16
    4 F-100 therapeutic diet,sach. 456g/CAR-30 CTN 31
    4 ReSoMal,84g sachet for 2 litres/CAR-130 CTN 2
    7 Amoxici.pdr/oral sus 125mg/5ml/BOT-100ml BOTLE 500
    7 Paracetamol 125mg/5ml elixir/BOT-60ml BOTLE 1,000
    8 Ferrous sulp.oral sol. 125mg/ml/BOT-30ml BOTLE 800
    8 Mebendazole 500mg tabs/PAC-100 PACK 700
    9 Chloroquine syrup 50mg/5ml/BOT-60ml BOTLE 600
    9 Nystatin oral sus 100,000IU/ml/BOT-30ml BOTLE 1,000
    10 Metronidazol pdr/o.s.200mg/5ml/BOT-100ml BOTLE 116
    11 Benzyl benzoate 25% lotion /BOT-1000ml BOTLE 192
    11 Tetracycline eye ointment 1%/TBE-5g TUBE 100
    12 Ampicillin pdr/inj 500mg vial/BOX-25 BOX 125
    13 Metronidazole inj 500mg/100ml vl/BOX-50 BOTLE 116
    16 MUAC,Child 11.5 Red/PAC-50 packs 9
    16 MUAC,Adult,without colour code/PAC-50 packs 7
    17 Scale, electronic,mother/child, 150kgx100g Scale 14
    17 Scale,baby,electronic,10kg,<5g> for SCs scale 1

    # Children received multi micronutrient sachets 15,291
    # Pregnant women and lactating mothers received Multi micronutrient tablets with MM tablets 7,825
    # Pregnant women and lactating mothers with Folic Acid 2,701
    # Children Dewormed 14,700

Sustainability Investments:  
  • 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
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