Cmam integration and complementary models ce
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Transcript of Cmam integration and complementary models ce
Presenter: Dr. Sisay Sinamo (MD, MPH)Nutrition Advisor,
East Africa Regional Office
Outline 1. Purpose of the presentation 2. Rational for Integration 3. Status of CMAM integration in Africa 4. MoH Integration: A case of Ethiopia 5. Aims of IYCF into CMAM ToT and planning
workshop6. Integrating IYCF into CMAM ToT 7. Integrating IYCF into CMAM planning workshop8. Action plans 9. Roll-out and lesson
1) Purpose of the presentation
To share experiences in CMAM integration in MoH system and progress made to generate evidence on complementary models
2) Rational for Integration Effective model for the rehabilitation
malnourished children
Operational - variety of settings (stable and emergency)
More than 500,000 acutely malnourished children were rehabilitated
Trained over 10,000 community health workers and 2000 health workers
2) Rational for Integration CMAM integration
into MoH system: 2008
Evidence on the project model effectiveness
Demand for national level programming
MoH readiness and ownership to take the lead: guideline and tools
Complementary models: 2010
• CMAM provides timely and appropriate intervention to improve child survival
• Lack of linkage between the ‘rehabilitative approach’ and preventive approaches
• Partners collaboration to develop the tools and test model
3) Status of CMAM Integration Currently almost all countries has CMAM guideline
CMAM is considered as part of regular health service activity
NGOs are called when the case load is high; except
fragile state
MoH is responsible for logistics transport and training
NGOs minimal support to ensure the quality of the program
3) MoH Integration: A Case of Ethiopia Strong national level Emergency Nutrition Coordination
SAM Guideline approved in 2007
CMAM decentralization to the health post level in 2008 All food insecure districts has trained man power
Health workers are responsible for case management and reporting
Community volunteers conduct screening, referral and follow up
4) Complementary Models Two complementary models are under
operational research in Ethiopia:
IYCF support into CMAM
PD Hearth in the context of CMAM and ENA
4.1) IYCF support into CMAM OR It is joint 2 years OR project between WV, SC US,
ENN and Hawassa University
The OR project is operational in two WV Ethiopia ADPs (one intervention and one control)
The goal of the study is to test and document
models of IYCF-CMAM integration. How best to integrate activities that support,
promote and protect IYCF into CMAM programs The efficacy of integrating IYCF support into
CMAM
4.1) IYCF support into CMAM OR Phase 1: 6 months
study design
stakeholder consultations;
ToT IYCF-CMAM integration
baseline IYCF assessments;
compilation and adaptation of IYCF-CMAM integration tools:
Phase 2: 12 months
Implementation
Training at district/site level
Testing of tools and job aids; wall chart, brief case and family folder
Data collection through cohort follow-up;
In-country mid-term review meeting
Phase 3: 6 months
Final IYCF assessment
data analysis and review,
In-country technical analysis and dissemination workshop,
Publication: research results and lessons learned
4.2) PD Hearth in Context of CMAM and ENA Is a joint 2 years OR project between WVE, WVK,
WITH and EHNRI
The overarching goal is to evaluate the effectiveness of:
Target Groups: children 6 – 24 months
the PD Hearth approach integrated into the context of the ENA & CMAM program on child growth and key child caring and feeding practices
Comparing with children in the ENA intervention and the CMAM program only.
4.2) PD Hearth in Context of CMAM and ENA Is a joint 2 years OR project between WVE, WVK,
WITH and EHNRI
The overarching goal is to evaluate the effectiveness of:
Target Groups: children 6 – 24 months
the PD Hearth approach integrated into the context of the ENA & CMAM program on child growth and key child caring and feeding practices
Comparing with children in the ENA intervention and the CMAM program only.
Improvement of child growth
Caregivers’ behavior change in ENA practices
4.2) PD Hearth in Context of CMAM and ENA
Pathway to the reduction of malnutrition
Counseling
Learning by doing
Caregivers’ behavior change in child feeding, caring and health seeking practices
Control
Intervention
4.2) PD Hearth in Context of CMAM and ENA
5) Lesson Increased national and regional partnership
opportunity and organizational visibility
WV and partners staff equipped in key CMAM competencies and quality of program improved over the past years
Provide opportunity to work with research institutes, universities in operational research
6) Way forward Provide ongoing technical support
CMAM projects & operational research projects
Document the lessons
Support the roll-out of project models and complementary models
Questions?